血清降钙素原对新生儿脓毒血症预后的预测价值

Significance of serum procalcitonin in prognosis of neonatal sepsis

目的评价血清降钙素原(PCT)对新生儿脓毒血症预后的预测价值。方法回顾性分析68例脓毒血症新生儿就诊时血清PCT水平与新生儿危重病例评分(NCIS)分级、住院期间死亡事件的相关性。采用受试者工作特征曲线(ROC)法分析脓毒血症新生儿就诊时血清PCT水平对于发生住院期间死亡事件的预测价值。利用Kaplan-Meier生存曲线分析不同血清PCT水平的脓毒血症新生儿住院期间的生存状况。结果住院期间死亡新生儿的血清PCT水平显著高于存活新生儿,且与NCIS分级有关。血清PCT水平对于预测新生儿发生住院期间死亡事件具有一定的价值(AUC=0.82,P<0.01)。血清PCT水平与新生儿住院期间的生存状况有关,在预测新生儿是否发生死亡事件方面,可以弥补NCIS的不足。结论血清PCT对于判断新生儿脓毒血症的预后具有重要意义。

Objective To evaluate the significance of serum procalcitonin （PCT） in prognosis of neonatal sepsis. Methods The serum PCT in 68 neonatal sepsis patients as well as its relationship with neonatal critical illness score （NCIS） and hospi- tal death events were retrospectively analyzed. Receiver operating characteristics （ROC） curve analysis was used to assess the predictive efficacy of serum PCT on hospital death events. Kaplan-Meier survival curve was used to describe the survival rate of neonatal sepsis patients at different serum PCT levels during their hospitalization. Results The serum PCT concentrations of neonates who died during the hospitalization were higher than those of survival neonates. The serum PCT levels were correlated with NCIS grades in all neonatal sepsis patients. More importantly, serum PCT had powerful predictive efficacy on hospital death events with the area under the ROC curve （AUC） of 0.82 （P〈0.01）. In addition, higher serum PCT level was associated with lower survival rate during hospital treatment, as identified by Kaplan-Meier survive curve and Log-rank analysis. The serum PCT may be a complement to NCIS grades in the prediction of neonatal death events. Conclusions Serum PCT levels have prognosticsignificance in neonatal sepsis.