C-反应蛋白在监测早产儿院内感染中的临床应用

The effect of CRP on monitoring nosocomial infection in preterm newborns

目的探讨C-反应蛋白(CRP)在早产儿院内感染诊断中的应用价值。方法住院250例早产儿(≤35周)院内感染监测中,动态检测其双-单倍CRP水平,同期测定血白细胞总数(WBC)、杆状核白细胞比例。其结果进行敏感度(SE)、特异度(SP)、预测值(PV)、似然比(LR)、准确度(AC)、误诊率(α)、漏诊率(β)、统计学参数Kappa值分析。结果早产儿存在院内感染时CRP升高明显,双-单倍血CRP的SE、AC值分别为95.8%,98.4%/83.3%,97.2%,高于WBC、杆状核WBC各值水平; 双-单倍血CRP的α、β值分别为1.3%,4.2%/1.3%,16.7%,低于WBC、杆状核WBC 各值水平;双一单倍血CRP的Kappa值均>0.75,Kappa值:双倍血CRP(0.911)>单倍血CRP(0.836)>WBC(0.514)>杆状核WBC(0.467);双倍血CRP检测P<0.05有统计学差异。结论在早产儿院内感染的诊断中,CRP值升高明显,对诊断院内感染灵敏,特别是双倍血标本CRP值升高更为精确、灵敏,具有较高的临床使用价值。

Objective To study the clinical effect of CRP on monitoring of nosocomial infection in preterm newborns. Methods 250 newborns of less than 35 weeds＇ gestational age in our hospital were involved in the study, the double-single concentration of CPR, and the white cell count（WBC）, as well as band count were examined. The sensitivity（SE）, specificity（SP）, predictive value（PV）,likelihood radio（LR）, accuracy（AC）, mistake diagnosetic rate （α）, omission diagnostic rate （β）, and statistical kappa index were calculated. Results There were obviously increased concentration of CRP in preterm infants with defined nosocomial infection. The SE and AC of double-single CRP were respectively 95.8%, 98.4%/83.3%, 97.2%, higher than that of WBC and band count; the α and β of double-single CRP were1.3%, 4.2%/1.3%, 16.7% respectively, lower than that of WBC and band count. There was significant high kappa index （ P 〈 0.05） in the double CRP sample. Conclusions The results indicate that the use of monitoring CRP concentration in preterm infants can increase accuracy and sencitivity of nosocomial infection diagnosis, in particular, the use of double CRP check is more effective and worth popularization in NLCU.