PCT、IL-6及CRP对新生儿宫内细菌感染的诊断价值

Diagnosis Value of PCT, IL-6 and CRP for Neonatal Intrauterine Bacterial Infection

目的：探讨新生儿宫内细菌感染采用降钙素原（PCT）、白细胞介素-6（IL-6）、及C反应蛋白（CRP）诊断的临床价值。方法：根据感染结局将2013年3月~2014年9月在我院分娩且有宫内感染高危因素的179例新生儿分为感染组（34例）和无感染组（145例）,检测两组的PCT、IL-6及CRP水平,并比较各项指标对宫内细菌感染的诊断价值。结果：感染组脐带血PCT、IL-6、CRP水平均高于无感染组,差异有统计学意义（P〈0.05）。感染组各单个指标阳性率、两指标联合的阳性率高于无感染组,差异均有统计学意义（P〈0.05）,感染组中PCT、IL-6阳性率高于CRP,PCT＋IL-6的阳性率高于PCT＋CRP、IL-6＋CRP,差异均有统计学意义（P〈0.05）。PCT＋IL-6的灵敏度、准确率高于单个指标及其他两个指标联合检测的结果,差异有统计学意义（P〈0.05）,各项指标检测的特异性比较,差异无统计学意义（P〉0.05）。结论：新生儿宫内感染采用脐带血PCT检测具有灵敏度高,特异性好的特点,联合IL-6检测是临床诊断新生儿宫内感染的最有效的方式。

Objective： To explore the clinical value of PCT, IL-6 and CRP in the diagnosis of neonatal intrauterine bacterial infection. Methods： 179 newborn infants with high risk factors of intrauterine infection in our hospital from March 2013 to September 2014 were divided into infection group（34 cases） and non-infection group（145 cases） according to the outcome. The PCT, IL-6 and CRP levels of two groups were detected and comparison of diagnosis value to intrauterine bacterial infection were launched. Results： The umbilical cord blood PCT, IL-6 and CRP levels in infection group were higher than these in non-infection group（P〈0.05）. The positive infection rate of each single index, two indicators jointed to neonatal intrauterine bacterial infection in infection group were higher than that in non-infection group（P〈0.05）. In infection group, the positive infection rate of PCT and IL-6 were higher than that of CRP, and the positive infection rate of PCT combined with IL-6 was higher than that of PCT combined with CRP and IL-6 combined with CRP（P〈0.05）.The sensitivity and accuracy of PCT combined with IL-6 to neonatal intrauterine bacterial infection were higher than that of single index or the other two indicators jointed（P〈0.05）; The comparison of specificity in different detecting indicator to neonatal intrauterine bacterial infection（P〉0.05）. Conclusion： Detecting umbilical cord blood PCT to diagnostic neonatal intrauterine bacterial infection has characteristic of high sensitivity, good specificity, which was the most effective way to diagnostic neonatal intrauterine bacterial infection once it combined with IL-6.