血清降钙素水平与血培养结果在新生儿败血症中的比较

Comparison of serum procalcitonin level and blood culture results in neonatal septicemia

目的探讨血清降钙素原(procalationin,PCT)在新生儿细菌性血流感染中的诊断价值。方法采用回顾性分析,将2011年6月-2013年3月本院和衢州市人民医院收治的512例新生儿分为新生儿败血症组、败血症高危因素组、非败血症高危因素组,随机抽取16例同期住院健康新生儿作为对照组。比较血培养结果与血清PCT浓度的关系及PCT浓度水平在革兰氏阴性细菌、革兰氏阳性细菌之间的差异。结果败血症组PCT水平明显增高有统计学意义(P<0.05),PCT和血培养的阳性率分别为76.5%和39.2%。以血培养检测结果作为对照,PCT的敏感性为85.7%,特异性为77.3%,阳性预测值和阴性预测值分别为41.3%、96.7%。PCT在革兰阴性细菌、革兰阳性细菌中的阳性率分别为95.5%和75.0%。结论检测PCT水平有助于临床对新生儿败血症的快速排除和诊断血流感染有一定的帮助。

Objective To study the diagnostic value of serum procalcitonin （PCT） in neonatal bacterial bloodstream infection. Methods Using retrospective analysis, 512 cases of newborns were divided into neonatal septicemia group, group with high risk factors of septicemia and group without hisk risk factors of septicemia. Meanwhile, 16 healthy newborns in the same period were taken as the contrul group. The relationship between blood cuhure results and serum PCT level was studied, and the serum PCT concentrations in gram negative bacteria and gram positive bacteria were compared. Results The level of PCT was significantly higher in sepsis group than that in other groups, and the difference was statistically significant （P 〈 0.05）. The positive rates of PCT and blood culture were 76.5% and 39.2% respectively in sepsis group. Taking blood culture results as control, the sensitivity of PCT was 85.7%, the specificity was 77.3%, the positive predictive value and negative predictive value were 41.3%, 96.7%. The positive rates of PCT in gram negative bacteria and gram positive bacteria were 95.5% and 75.0%. Conclusion The detection of PCT level is helpful for rapid differentiation of neonatal sepsis and diagnosis of bloodstream infection.