ROC曲线评价多参数对新生儿感染的诊断价值

Diagnostic value of multi-parameter evaluation by ROC curve for neonatal infection

目的探讨多个实验室指标对于新生儿感染的早期诊断价值。方法选取确诊感染入院的新生儿30例,检测其血降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)和白细胞计数(WBC),并以未感染的新生儿作为对照组,比较两组受试者上述指标的水平,用ROC曲线评价这些指标对于新生儿感染诊断的临床应用价值。结果新生儿感染组各参数均高于对照组,差异有统计学意义(P<0.05);由ROC曲线可知,PCT和hs-CRP敏感度和特异性达100.0%,TNF-α敏感度为96.7%,特异性为99.3%;IL-6和IL-8敏感度均为93.3%,但特异性分别为73.3%和80.0%,WBC则为70.0%和80.0%。结论各参数均可以用于新生儿感染诊断,但灵敏度与特异性均较高的是PCT和hs-CRP,其次为TNF-α;IL-6和IL-8敏感性虽高,但其特异性不甚满意;WBC诊断价值虽最小,但却是临床必不可少的常规观察指标。

Objective To investigate the early diagnosis value of multiple laboratory indicators for neonatal in‐fection .Methods 30 hospitalized neonates with infection were selected and 30 normal neonates were selected as the controls .The blood PCT ,hs‐CRP ,IL‐6 ,IL‐8 ,TNF‐α and WBC were detected .The levels of above indicators were compared between the two group .The clinical application value of these indicators for the diagnosis of neonatal infec‐tion was evaluated by using the ROC curves .Results The various parameters in the neonatal infection group were higher than those in the control group（P〈0 .05）;the ROC curves indicated that the sensitivity and specificity of PCT and hs‐CRP reached 100 .0% ,which of TNF‐αwere 96 .7% and 99 .3% respectively ;the sensitivity of IL‐8 and IL‐6 were 93 .3% and their specificity was 73 .3% and 80 .0% respectively ;the sensitivity and specificity of WBC were 70 .0% and 80 .0% respectively .Conclusion The above parameters can be used to diagnose neonatal infection ,PCT and hs‐CRP have the higher sensitivity and specificity ,followed by TNF‐α;although IL‐8 and IL‐6 have higher sensi‐tivity ,but their specificity is unsatisfactory ;WBC has the minimal diagnostic value ,but is an indispensable routine observation indicator in clinic .