降钙素原(PCT)、hs-CRP在新生儿败血症早期诊断中的价值

Value of Procalcitonin and Hypersensitive C-reactive Protein for Early Diagnosis of Neonatal Sepsis

目的探讨PCT、hs-CRP在新生儿败血症早期诊断和疗效观察中的价值。方法对本院住院73例新生儿患儿根据感染程度分为二组即败血症组、局部细菌感染组,另选取本院新生儿科30例同期无感染的儿童为对照组,对观察组73例和对照组30例的患儿同时进行PCT、hs-CRP、血培养、WBC、ESR五项目平行检测,并做对比分析。结果败血症组PCT、hs-CRP、WBC、ESR四项目水平均明显高于局部细菌感染组和对照组,差异有统计学意义(P<0.05);败血症组中PCT、hs-CRP、血培养、WBC、ESR五项目阳性检出率为PCT(93.75%)>hs-CRP(81.2%)>血培养(46.8%)>WBC(34.3%)>ESR(28.1%);PCT、血培养败血症组阳性率均明显高于局部细菌感染组,差异有统计学意义(P<0.01),hs-CRP、WBC、ESR局部细菌感染组阳性率均接近于败血症组,差异无统计学意义(P>0.05);PCT结果经抗生素治疗后快速下降,hs-CRP结果抗生素治疗后下降缓慢。结论 hs-CRP可以作为新生儿一般性感染的实验室指标;PCT可作为新生儿败血症早期诊断的指标,动态监测PCT水平可以观察疗效,指导临床用药。

Objective To study the value of procalcitonin （PCT）, hypersensitive C- reactive protein （bs - CRP） for ear- ly diagnosis and curative effect observation of neonatal sepsis. Methods A total of 73 neonatal patients in Central Hospital of Shaoyang City were divided into two groups, sepsis group and local bacterial infection group, based on their infection degree. An- other 30 neonates who visited the same hospital during the same period and were diagnosed as without infection symptoms were recruited into control group. PCT, hs - CRP, blood culture, white blood cell （WBC） and erythrocyte sedimentation rate （ESR） were detected in all the groups. Results The levels of PCT, hs - CRP, WBC and ESR in sepsis group were all significantly higher than those in local infection group and control group （ P 〈 0.05）. The positive rates of PCT, hs - CRP, blood culture , WIN2 and ESR in sepsis group were 93.75%, 81.2%, 46.8%, 34.3% and 28.1%, respectively. The positive rates of PCT and blood culture in sepsis group were significantly higher than those in local infection group （P 〈 0.01）, while the positive rates of hs - CRP, WBC and ESR in sepsis group were close to those in local infection group and showed no statistical difference （P 0.05）. After antimicrobial treatment, the level of PCT decreased rapidly, while the level of hs - CRP reduced slowly. Conclusions Hs - CRP can be used as a marker of neonatal general infection, and PCT can be used as a maker for early diagnosis of neonatal sepsis. Dynamic monitoring of PCT level can be helpful for observing curative effect and guiding clinical medication.