血清TSH和FT3及PCT在新生儿感染性疾病中的表达水平及诊断意义  

Significance of combined detection of serum TSH,FT3 and PCT in the diagnosis of neonatal infectious diseases

作　　者：黎国春 罗妮娜 LI Guochun;LUO Nina(Department of Neonatology,Yiling People's Hospital,Yichang,Hubei 443100,China)

机构地区：[1]宜昌市夷陵区人民医院新生儿科,湖北宜昌443100

出　　处：《热带医学杂志》2024年第5期726-729,734,F0003,共6页Journal of Tropical Medicine

基　　金：湖北省自然科学基金(2022CFB796)。

摘　　要：目的探究感染性疾病患儿血清促甲状腺激素(TSH)、游离总三碘甲状腺素原氨酸(FT3)、降钙素原(PCT)在新生儿感染性疾病的表达情况,分析其诊断意义。方法选取2019年3月-2022年3月在宜昌市夷陵区人民医院新生儿科就诊的100例发热新生儿作为研究组,按照感染类型分为细菌感染组(46例)和病毒感染组(54例),根据新生儿危重症评分标准分为非危重组(38例)、危重组(28例)及极危重组(34例)。另选取经检查无异常的健康新生儿50名作为对照组。分别检测研究组和对照组新生儿血清TSH、FT3和PCT的表达水平,对比分析各指标差异。Logistic回归分析新生儿感染性疾病影响因素;采用受试者工作特征(ROC)曲线分析上述指标对新生儿感染性疾病的诊断效能。结果细菌感染组患儿血清TSH和PCT水平高于病毒感染组,差异均有统计学意义(t=7.626、9.866,P均<0.05),血清FT3水平低于病毒感染组,差异有统计学意义(t=10.654,P<0.05)。随患儿病情加重,血清TSH和PCT表达水平上升(F=31.449、69.274),FT3水平降低(F=60.396),对照组、非危重组、危重组和极危重组4组之间比较,差异均有统计学意义(P均<0.05)。TSH、FT3、PCT以及三者联合诊断新生儿感染性疾病的曲线下面积(AUC)分别为0.875、0.867、0.911、0.966,三者联合诊断AUC均高于各指标独立诊断(Z=3.137、3.579、2.749,P=0.002、<0.001、0.006),三者联合诊断灵敏度为90.00%,特异度92.00%。结论TSH、FT3和PCT联合诊断新生儿感染性疾病具有较高价值,对判断感染的病原菌以及患儿病情严重程度具有参考价值。Objective To detect the expression of serum thyroid-stimulating hormone(TSH), free total triiodothyronine(FT3) and procalcitonin(PCT) in neonates with infectious diseases, and explore the significance of the combination of the above serum indicators in the diagnosis of neonatal infectious diseases. Methods A total of 100 febrile newborns treated in the Department of Neonatology of Yiling People's Hospital from March 2019 to March 2022 were selected as the study group.According to the type of infection, they were grouped into bacterial infection group(46 cases) and viral infection group(54cases). And according to the neonatal critical illness scoring standard, they were divided into non-critical group(38cases), critical group(28 cases) and extremely critical group(34 cases). Another healthy 50 children with no abnormality were selected as the control group. The expression levels of serum TSH, FT3 and PCT in infants and young children in the above study group and control group were measured respectively, and the differences of each index were compared and analyzed. Logistic regression was used to analyze the influencing factors of neonatal infectious diseases. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic performance of the above indicators for neonatal infectious diseases. Results The levels of serum TSH and PCT in the bacterial infection group were higher than those in the virus infection group;all the differences were statistically significant(t=7.626, 9.866;all P<0.05), and the level of serum FT3was lower than that in the virus infection group;the difference was statistically significant(t=10.654, P<0.05). With the aggravation of the disease, the expression levels of serum TSH and PCT increased(F=31.449, 69.274), and the level of FT3 decreased(F=60.396);there were significant differences among the control group, non-critical group, critical group and extremely critical group(all P<0.05). The areas under the curve(AUC) of TSH, FT3, PCT and their combination for the diagnosis of

关 键 词：新生儿感染性疾病 促甲状腺激素 游离总三碘甲状腺素原氨酸 降钙素原 

分 类 号：R722.13[医药卫生—儿科]