C-反应蛋白在早产儿感染性疾病诊断中的应用评价

Application and evaluation of C-reactive protein on the diagnosis of infectious diseases in premature infants

目的探讨超敏C-反应蛋白(hs-CRP)在早产儿感染性疾病(ID)诊断中的应用价值。方法对2012年1月至2013年12月在我院就诊的162例早产儿的临床资料行回顾性分析,根据有无疾病及感染与否分为3组,ID组(n=46),NID组(n=66),对照组(n=50),比较治疗前后的hs-CRP、血细胞参数(WBC、PLT、NGR%、ESR)、感染阳性检出率及不同病原体hs-CRP水平。结果 (1)3组一般资料组间比较差异均无统计学意义(P>0.05)。(2)ID组的hs-CRP阳性检出率明显高于WBC,而NID组的WBC阳性检出率明显高于hs-CRP,差异均有统计学意义(P<0.05)。(3)较之病毒、支原体等其他病原体,细菌感染的hs-CRP水平明显高,差异有统计学意义(P<0.05),而G+菌与G-菌感染比较,hs-CRP水平差异无统计学意义(P>0.05)。(4)组内比较:较之治疗前,ID组治疗后的hs-CRP、WBC、NGR%、ESR,NID组的hs-CRP、WBC均明显下降,差异有统计学意义(P<0.05);ID组的PLT,NID组的PLT、NGR%、ESR,对照组各指标,差异均无统计学意义(P>0.05)。组间比较:治疗前,ID组、NID组的hs-CRP、WBC明显高于对照组,ID组的NGR%、ESR明显高于NID组、对照组,差异均有统计学意义(P<0.05);NID组与对照组的NGR%、ESR,各组的PLT以及治疗后各组指标间,差异均无统计学意义(P>0.05)。结论 hs-CRP虽可作为早产儿ID,尤其是细菌感染的早期诊断指标,但实际应用中仍需结合临床表现以及其他非特异性指标,以提高诊断准确率。

ObjectiveTo observe the clinical value of high sensitivity C-reactive protein （hs-CRP） on the diagnosis of infectious diseases （ID） in premature infants.MethodsThe clinical materials of 162 cases were reviewed and analyzed from Jun. 2012 to Dec. 2013. They could be divided into three groups including the ID group （n=46）, NID group （n=66）, and control group by the disease and infection or not to compare the hs-CRP, blood cell parameters （WBC, PLT, NGR%, ESR）, positive rate of infection and level of hs-CRP in different pathogens.Results（1） There were no significant differences by the general data between the three groups （P〉0.05）. （2） The positive detection rate of the hs-CRP in the ID group was significantly higher than the WBC, and the positive detection rate of the WBC in the NID group was significantly higher than the hs-CRP. There were significant differences between them （P〈0.05）. （3） The level of hs-CRP with bacterial infection was significantly higher than the other pathogens＇ （P〈0.05）. There were no significant differences between the G^＋ bacteria and G^- bacteria＇s （P〉0.05）. （4） Compared with pretherapy, the hs-CRP, WBC, NGR% and ESR in the ID group, and the hs-CRP, WBC in the NID group were significantly decreased after treatment. There were significant differences between them （P〈0.05）. There were no significant differences between the PLT in the ID group, PLT, NGR%, ESR in the NID group, and each index in the control group （P〉0.05）. The hs-CRP, WBC in the ID and NID groups were significantly higher then the control group, and the NGR%, ESR in the ID group were significantly higher then the NID and control group in pretherapy （P〈0.05）. There were no significant differences between the NGR%, ESR in the NID and control group, each group’ s PLT, and each index after treatment （P〉0.05）.ConclusionAlthough hs-CRP can be used as the newborn ID, especially early diagnosis index of bacterial infection, but in practical application we need to combine the clinical manifestations and other nonspecific index for improving the accuracy rate of diagnosis.