SAA、PCT和hs-CRP的联合检测在预测新生儿败血症中的临床价值  

Clinical value of combined detection of SAA,PCT and hs-CRP in predicting neonatal septicemia

作　　者：陆佳丽[1] 吴云路 LU Jiali;WU Yunlu(Department of Laboratory,Shaoxing Women and Children's Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市妇幼保健院检验科,浙江绍兴312000

出　　处：《基础医学与临床》2025年第3期370-374,共5页Basic and Clinical Medicine

基　　金：浙江省医药卫生科技计划(2024KY485)。

摘　　要：目的探讨血清淀粉样蛋白A(SAA)、降钙素原(PCT)和超敏C反应蛋白(hs-CRP)对新生儿败血症的预测及疗效评估的临床价值。方法收集院内2021年1月至2024年4月63例临床诊断败血症新生儿和50例非败血症健康体检新生儿作为研究对象,比较临床特征以及SAA、PCT和hs-CRP的检测结果,同时比较不同治疗效果患儿的SAA、PCT和hs-CRP的检测结果。结果两组新生儿在年龄、出生体质量、分娩方式等方面差异无统计学意义,败血症患儿血培养阳性率仅为12.7%,以革兰阳性球菌为主;败血症患儿的SAA、PCT和hs-CRP水平显著高于对照组(P<0.01);三者的受试者工作特征(ROC)曲线下面积(AUC)均高于0.7,联合检测时的AUC达到0.9,敏感性为90.55%;三者在治疗有效的患儿中数值显著降低(P<0.01),且联合检测评估疗效时,AUC为0.77,敏感性和特异性分别为65.36%和82.45%。结论联合检测SAA、PCT和hs-CRP对诊断新生儿败血症有较高的诊断价值且可以更好地评估疾病的疗效。Objective To study the performance of serum amyloid A(SAA),procalcitonin(PCT)and hypersensitive C-reactive protein(hs-CRP)in predicting and evaluating therapeutic efficacy of neonatal septicemia.Methods Totally 63 neonates with clinical diagnosis of septicemia and 50 healthy neonates as control from January 2021 to April 2024 were enrolled this study.The clinical features and the results of SAA,PCT and hs-CRP were compared between the two groups;The results of SAA,PCT and hs-CRP of neonates suffering from septicemia with different therapeutic outcomes were compared.Results There was no significant difference in clinical features(age,birth weight,mode of delivery,etc.)between the two groups,and the positive rate of blood culture in neonates with septicemia was only 12.7%,gram-positive cocci were the main pathogens;The level of SAA,PCT and hs-CRP in sepsis group was significantly higher than those in control group(P<0.01);The area under the receiver operating characteristic(ROC)curve(AUC)of the three indexes was higher than 0.7,and the AUC of the combined detection was 0.9,the sensitivity was 90.55%;The results of the three indexes were significantly decreased in effective group after treatment(P<0.01),and the AUC of the joint detection in evaluating therapeutic efficacy was 0.77,the sensitivity and specificity were 65.36% and 82.45% respectively.Conclusions A combined detection of SAA,PCT and hs-CRP shows high value in diagnosis and prognosis prediction of neonatal septicemia.

关 键 词：血清淀粉样蛋白A 降钙素原 超敏C-反应蛋白 败血症 新生儿 

分 类 号：R446.11[医药卫生—诊断学]