血清降钙素原测定在新生儿细菌感染性疾病中的诊断价值

Diagnostic value of procalcitonin test in neonatal bacterial infections

目的评价血清降钙素原(PCT)在新生儿细菌感染性疾病中的诊断价值。方法选择2013年2—10月被蚌埠医学院第二附属医院NICU收治的经病原学检测,临床确诊为新生儿细菌感染性疾病的50例患儿作为研究对象,并根据感染严重程度评分(SSS)分组,其中重症感染组26例,一般感染组24例。另外选取32例健康新生儿作为对照。所有患儿在使用抗生素前采集血液标本检查降钙素原、血常规、生化常规以及超敏C反应蛋白。降钙素原≥0.5 ng/ml为阳性,超敏C反应蛋白≥8 mg/L为阳性,白细胞计数≥20×109/L为阳性。用统计软件SPSS 13.0进行数据分析。结果细菌感染组中PCT水平为(7.31±4.28)ng/ml,hs-CRP水平为(20.08±14.16)mg/L,白细胞计数(17.15±8.24)×109/L;细菌感染组PCT、hs-CRP水平及白细胞计数均高于健康对照组,与健康对照组相比差异有统计学意义(P<0.05)。细菌感染组的PCT阳性率明显高于hs-CRP及WBC的阳性率,重症感染组的PCT阳性率明显高于一般感染组和健康对照组,一般感染组的PCT阳性率明显高于健康对照组,重症感染组88.5%的PCT水平在2 ng/ml以上,一般感染组仅20.8%的患儿PCT在2 ng/ml以上,以上差异均有统计学意义(P<0.05)。结论相比于WBC和hs-CRP,PCT检测可作为临床早期诊断新生儿细菌感染的重要指标,PCT值越高,疾病的危险度越高。

Objective To evaluate the value of procalcitonin（ PCT） test in the diagnosis of neonatal infectious diseases.Methods Fifty neonates with bacterial infection disease confirmed by pathogen detection in NICU of our hospital from February to October in 2013 were enrolled in this study,and were divided into serious infection group（ n = 26） and mild infection group（ n = 24） by using Symptom Severity Score（ SSS）. 32 normal neonates were recruited as control. The blood sample of all individuals were collected to PCT test,the routine blood test,the routine biochemical test and hs-CRP test before the use of antibiotics. PCT≥0. 5 ng /ml,hs-CRP≥8 mg /L and leucocyte count≥20 × 10^9/L stranded a positive test. SPSS 13. 0 soft was employed to analyze the data. Results In the patients with bacterial infections,the level of PCT was（ 7. 31 ± 4. 28） ng /ml,the level of hs-CRP was（ 20. 08 ± 14. 16） mg /L and leucocyte count was（ 17. 15 ± 8. 24） ×10^9/L,which were higher than those in the normal control,the difference between the two groups was statistically significant（ P〈0. 05）. The rate of positive PCT test was higher than that of hs-CRP and WBC,the serious infection group was with the highest positive rate of PCT,and followed by the mild infection group,and by the normal control group. PCT level in 88. 5% of patients in the serious infection group was above 2 ng /ml,while only 20. 8% of patients in the mild infection group was above 2 ng /ml,the difference was statistically significant（ P 〈0. 01）. Conclusion Compared with WBC and hs-CRP,PCT can be used as an important index in the clinic early diagnose of neonatal bacterial infection diseases,and the higher levels of PCT is related to the severity of diseases.