降钙素原与C反应蛋白在新生儿社区获得性肺炎中的应用价值

Application values of procalcitonin and C-reactive protein in neonatal community-acquired pneumonia

目的:探讨血清降钙素原(PCT)及C反应蛋白(CRP)在新生儿社区获得性肺炎(CAP)中的应用价值。方法:选取该院新生儿274名,分为细菌组、病毒组和健康组。按照国际血液学标准化委员会(ICSH)制定的评价标准,分别采用电化学发光法,免疫比浊法对PCT和CRP进行检测分析。结果:细菌组与病毒组PCT、CRP和WBC之间比较分别为PCT(F=21.349,P<0.05)、CRP(F=234.988,P<0.05)、WBC(F=73.96,P<0.05);细菌组与健康组比较,差异有统计学意义PCT(F=21.390,P<0.05)、CRP(F=262.365,P<0.05)、WBC(F=87.235,P<0.05);病毒组PCT、CRP与健康组比较,差异无统计学意义,PCT(F=3.032,P>0.05)、CRP(F=2.684,P>0.05)。细菌组中PCT、CRP两种不同的检测指标来诊断细菌感染的敏感性和特异性进行χ2检验,差异有统计学意义(χ2=11.812,P<0.05)。以PCT>0.5 ng/ml为界,诊断细菌感染的敏感性为80.4%(74/92),特异性为96.6%(86/89),以CRP>8 mg/L为界,诊断细菌感染的敏感性为67.4%(62/92),特异性为92.1%(82/89)。结论:PCT检测是判断新生儿社区获得性肺炎(CAP)的良好指标,不仅对全身细菌感染诊断具有良好的敏感性和特异性,而且能动态监测患者病情变化、反映感染的严重程度,为临床医师评估病情转归提供客观依据;血清PCT检测结果可反映抗菌药物的疗效,能为临床医师及时调整抗菌药物提供依据,应尽早开展PCT和CRP检测。

Objective： To explore the application values of procalcitonin （PCT） and C -reactive protein （CRP） in neonatal community -acqUired pneumonia （CAP） . Methods： A total of 274 neonates were selected from the hospital and divided into bacterium group, virus group and healthy control group. According to the evaluation criteria designed by ICSH, electrochemiluminescence and immunoturbidimetry were used to detect PCT and CRP respectively. Results： There were statistically significant differences in PCT and CRP levels, white blood cell （WBC） count between bacterium group and virus group （ F = 21. 349, P 〈 0. 05 ; F = 234. 988, P 〈 0.05 ; F = 73.96, P 〈 0. 05 ） . There were also statistically significant differences in PCT and CRP levels, WBC count between bacterium group and healthy control group （ F = 21. 390, P 〈 0. 05 ; F = 262. 365, P 〈 0. 05 ; F = 87. 235, P 〈 0. 05 ） . There was no statistically significant difference in PCT and CRP levels between virus group and healthy control group （ F = 3. 032, P 〉 0. 05 ; F = 2. 684, P 〉 0. 05 ） . There were statistically sig- nificant differences in sensitivity and specificity between PCT and CRP in diagnosis of viral infection in bacterium group （X2 = 11. 812, P 〈 0.05） . Taking PCT 〉0. 5 ng/ml as critical value, the sensitivity and specificity of PCT in diagnosis of bacterial infection were 80. 4% （74/92） and 96. 6% （86/89）, respectively; taking CRP 〉 8 mg/L as critical value, the sensitivity and specificity of CRP in diagnosis of bacterial infection were 67.4% （62/92） and 92. 1% （82/89） , respectively. Conclusion： PCT is a good indicator to detect neonatal CAP, which not only has high sensitivity and specificity in diagnosis of systematic bacterial infection, but also can monitor change of the disease dynamically, reflect the severity of bacterial infection and provide an objective basis for clinicians to evaluate prognosis of the disease; serum PCT detection results can reflect the curative effect of antibacterial drugs and provide a basis for clinicians to adjust antibacterial drugs timely, PCT and CRP detection should be carried out as soon as possible.