血清降钙素原联合超敏C反应蛋白检测在新生儿肺炎合并脓毒症中的临床应用

Clinical Application of Serum Procalcitonin and High Sensitivity C Reactive Protein Detection in Neonatal Pneumonia Complicated with Sepsis

目的:探讨血清降钙素原(PCT)联合超敏C反应蛋白(hs-CRP)检测在新生儿肺炎合并脓毒症中的临床应用价值。方法:选取2012年10月至2014年1月我院治疗的新生儿肺炎患儿90例,其中单纯肺炎27例,合并轻度脓毒症32例,合并重度脓毒症31例。将单纯肺炎患儿作为对照组,合并轻度脓毒症患儿作为研究组A,合并重度脓毒症患儿作为研究组B,检测三组患儿PCT以及hs-CRP水平,分析二者联合检测的应用价值。结果:对照组、研究组A、研究组B血清PCT、hs-CRP水平两两比较差异均有统计学意义(P<0.05)。血清PCT、hs-CRP水平诊断新生儿肺炎合并脓毒症的ROC曲线下降面积分别为0.857、0.781,PCT诊断肺炎合并脓毒症的最佳节点为≥2 ng/m L,准确度为74.32%;hs-CRP诊断肺炎合并脓毒症的最佳节点为≥55mg/L,准确度为67.86%。二者联合诊断,敏感度、特异度、阳性似然比、阴性似然比和准确度分别为91.37%、86.34%、4.13、0.13、88.12%。结论:新生儿肺炎合并脓毒症血清PCT、hs-CRP水平与病情的严重程度呈正相关,在临床诊断中具有重要的应用价值。

Objective： To explore the application value of serum procalcitonin（ PCT） and high sensitivity C reactive protein（ hs-CRP）detection in neonatal pneumonia combined with sepsis. Methods： Ninety cases of neonatal pneumonia in our hospital from October 2012 to January 2014 were selected,among which there were 27 cases of simple pneumonia as the control group,32 cases complicated with mild sepsis as the A study group,31 cases complicated with severe sepsis as the B study group. The serum PCT and hs-CRP levels of the three groups were detected,of which the application value was analyzed. Results： There were significant differences in PCT and hs-CRP levels of the control group,A study group and B study group between each two groups（ P〈0.05）. The ROC curve areas of serum PCT,hs-CRP levels in the diagnosis of neonatal pneumonia complicated with sepsis were 0.857,0. 781,and the PCT level optimal node in the diagnosis of neonatal pneumonia complicated with sepsis was more than or equal to 2 ng / m L,of which the accuracy was 74.32%,while the hs-CRP level optimal node in the diagnosis of neonatal pneumonia complicated with sepsis was more than or equal to 55 mg / L,of which the accuracy was 67. 86%. Both the two combination in the diagnosis of neonatal pneumonia complicated with sepsis,the sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and accuracy were 91. 37%,86.34%,4.13,0.13,88. 12%.Conclusion： The serum PCT,hs-CRP levels of pneumonia complicated with sepsis are positively correlated with the severity of the disease,which have important application value in clinical diagnostics.