PCT、CRP、IL-6对新生儿肺部感染的检测诊断意义

Diagnostic value of PCT,CRP and IL-6 in detecting neonatal pneumonia

目的 探讨血清降钙素原（PCT）、C－反应蛋白（CRP）、白介素－6（IL-6）在新生儿肺部感染时的诊断价值。方法 以徐州市儿童医院新生儿科2013年1月至2014年1月患肺炎新生儿35例作为感染组，选取20例足月正常新生儿作为对照组，检测新生儿血清中PCT、CRP和IL-6的水平，分析其表达情况和联合检测的敏感性、特异性、阳性预测率和阴性预测率，并用Western blot法检测正常组新生儿和感染组患儿血清中3种蛋白的表达水平的变化。结果 感染组患儿血清中PCT、CRP和IL-6的水平均高于正常组，差异有显著意义（ t值分别为9．48、24．68和19．17，均P＜0．05）；三者联合检测后的敏感性、特异性、阳性预测率和阴性预测率的值分别为98．7％，89．7％，85．5％，90．9％，与单独检测相比，差异均有统计学意义（χ^2值分别为25．15、23．58、22．57和23．08，均P＜0．05）；Western blot检测结果显示，正常组新生儿组织中PCT、CRP和IL-6的表达水平均低于感染组患儿血清中的水平，且差异有显著意义（t值分别为6．89、9．19和11．27，均P＜0．05）。结论 PCT、CRP和IL-6三者联合检测提高了对新生儿肺炎的敏感性和特异性，对临床诊断具有重要价值。

Objective To explore the diagnostic value of serum procalcitonin （PCT）, C-reactive protein （CRP） and interleukin-6 （IL-6） in neonatal pneumonia .Methods Thirty-five cases with neonatal pneumonia admitted in Xuzhou Children ’ s Hospital from January 2013 to January 2014 were selected in infection group , and 20 normal full-term newborns were recruited in control group .Serum levels of PCT , CRP and IL-6 of two groups were detected .The expressions of these three factors and the sensitivity , specificity, positive predictive rate and negative prediction rate of joint detection were recorded .Western blot method was used to detect the expression changes of the three in the control group and the infection group .Results The levels of PCT , CRP and IL-6 in the infection group were obviously higher than those of the control group, and the differences were significant （t value was 9.48, 24.68 and 19.17, respectively, all P 〈0.05）.The sensitivity, specificity, positive predictive rate and negative prediction rate of combined detection were 98.7%, 89.7%, 85.5% and 90.9%, respectively, which were significantly different from those of single detection （χ^2 value was 25.15, 23.58, 22.57 and 23.08, respectively, all P 〈0.05）.Western blot test results showed that the expressions of PCT , CRP and IL-6 in the control group were markedly lower than those in the infection group , and the differences were significant （t value was 6.89, 9.19 and 11.27, respectively, all P〈0.05）.Conclusion Combined detection of PCT, CRP and IL-6 can improve the sensitivity and specificity of neonatal pneumonia , which has important value in clinical diagnosis .