血清降钙素原检测在新生儿细菌感染性疾病诊断中的应用

Application of serum procalcitonin test in diagnosis of neonatal bacterial infectious diseases

目的探讨降钙素原(PCT)在新生儿细菌感染性疾病中的诊断价值。方法用酶联免疫荧光分析技术对90例新生儿血清PCT进行检测。细菌学培养结果阳性、临床有发热感染症状符合细菌感染诊断的归为观察组(48例);细菌学培养结果为阴性、临床资料未显示有感染症状的归为对照组(42例)。记录同期检测的PCT、白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)结果 ,计算各项指标的灵敏度和特异度,绘制受试者工作特征(ROC)曲线并进行比较。结果 PCT灵敏度87.50%、特异度85.71%、阳性预测值(PPV)87.50%、阴性预测值(NPV)85.71%;CRP灵敏度81.25%、特异度83.33%、PPV 84.78%、NPV 79.54%;IL-6灵敏度93.75%、特异度71.43%、PPV 78.95%、NPV 90.91%;WBC灵敏度68.75%、特异度57.14%、PPV64.70%、NPV 61.53%。PCT、CRP、IL-6、WBC用于新生儿细菌感染性疾病诊断的ROC曲线下面积分别为0.859、0.852、0.803、0.647。结论与其他感染性指标相比,PCT在诊断新生儿细菌感染性疾病时有较高的灵敏度和特异度,操作方法简便可行,能为诊断提供实验室依据。

Objective To investigate the diagnostic value of procalcitonin（PCT） in bacterial infectious diseases for newborns . Methods Using enzyme‐linked immune fluorescence analysis technology to determine PCT of 90 samples of neonatal serum .The Observation group（48 cases） and control group（42 cases） were grouped according to the gold standard which were microbial cul‐ture result of sterile body fluid and clinical diagnosis .Recorded the values of PCT ,WBC ,CRP and IL‐6 detected in the same period , then calculate the sensitivity and specificity ,and draw the ROC curve to compare sensitivity and specificity between PCT and the other infectious indicators .Results The sensitivity and specificity of PCT were 87 .50% and 85 .71% respectively ,the positive pre‐dictive value（PPV） and negative predictive value（NPV）of it were 87 .50% and 85 .71% .However ,the sensitivity and specificity of CRP were 81 .25% and 83 .33% ,the PPV and NPV of it were 84 .78% and 79 .54% .The sensitivity and specificity of WBC were 68 .75% and 57 .14% ,the PPV and NPV of it were 64 .70% and 61 .53% .The sensitivity and specificity of IL‐6 were 93 .75% and 71 .43% ,the PPV and NPV of it were 78 .95% and 90 .91% .In addition to that ,the area under the ROC of PCT ,CRP ,IL‐6 and WBC ,which were 0 .859 ,0 .852 ,0 .803 and 0 .647 respectively .Conclusion Compared with the other 3 infectious indicators ,PCT has high sensitivity and specificity in the diagnosis of neonatal bacterial infection diseases .Moreover ,the detection method of PCT is simple and feasible ,PCT could also provide laboratory basis for the diagnosis .