血清降钙素原在新生儿感染早期诊断中的价值

Value of Serum Procalcitonin Levels in Early Diagnosis of Neonatal Infection

目的探讨血清降钙素原(procalcitonin,PCT)在新生儿感染早期诊断中的价值。方法使用全自动免疫荧光分析仪、采用半定量固相免疫测定法检测78例疑似感染的患儿(感染组)和82例非感染的患儿(对照组)血清PCT水平,使用全自动生化分析仪、采用免疫散射比浊法检测2组患儿血清C反应蛋白(C-reactive protein,CRP)水平,计算灵敏度、特异度、阳性预测值、阴性预测值及确定最佳临界值,并进行2组比较。结果感染组血清PCT、CRP水平均显著高于对照组(均P<0.01)。ROC曲线分析结果显示,PCT的ROC曲线下的面积为0.879,最佳临界值为0.51μg.L-1;CRP的ROC曲线下的面积为0.694,最佳临界值为8.01 mg.L-1。PCT的特异度、阳性预测值均显著低于CRP(均P<0.05),PCT的ROC曲线下的面积、灵敏度、阴性预测值、约登指数均显著高于CRP(均P<0.05)。结论PCT的测定有助于新生儿感染的早期诊断。

Objective To explore the value of serum procalcitonin （PCT）in early diagnosis of neonatal infection. Methods The levels of serum PCT were detected by semi-quantitative solid phase immunoassay with automatic fluorescence immunoassay analyzer and the levels of serum C-reactive protein（CRP）were measured by immune scattered nephelometry with automatic biochemical analyzer in 78 neonates with suspected infection（infection group）and 82 neonates without infection （control group）. The sensitivity,specificity,positive predictive value ,negative predictive value and cutoff value were compared between the two groups. Results The levels of serum PCT and CRP in infection group were significantly higher than those in contro! group （P〈0.01）.The area under ROC curve was 0.879 for PCT （cutoff value,0.51 μg·L^-1）and 0.694 for CRP （cutoff value,8.01 mg·L^-1）.Compared with CRP,the specificity and positive predictive value of PCT significantly decreased but the area under ROC curve, sensitivity, negative predictive value and Youden＇s index of PCT obviously increased（P〈0.05 ）.