降钙素原联合C-反应蛋白、白细胞诊断新生儿感染性肺炎临床分析

Clinical analysis of procalcitonin combined with C-reactive protein and white blood cell in diagnosis of neonatal infectious pneumonia

目的研究降钙素原(PCT)联合C-反应蛋白(CRP)、白细胞(WBC)诊断新生儿感染性肺炎的临床影响。方法选取2012年7月至2014年7月佛山市南海区第六人民医院收治的110例患有感染性肺炎的新生儿作为观察组,其中细菌性感染患儿55例,病毒性感染患儿55例,随机选取无任何感染性疾病的新生儿55例作为对照组,抽取静脉血检测降钙素原(PCT)、C-反应蛋白(CRP)、白细胞(WBC),观察并比较三组间的PCT、CRP、WBC水平。结果观察组中细菌感染患儿的PCT水平(0.81±0.25)ng/ml,CRP水平(22.53±3.28)mg/L,WBC水平(16.86±2.63)×109/L,病毒性感染患儿的PCT水平(0.57±0.37)ng/ml,CRP水平(9.35±2.63)mg/L,WBC水平(10.51±2.45)×109/L,对照组中PCT水平(0.31±0.34)ng/ml,CRP水平(5.23±2.21)mg/L,WBC水平(6.53±2.41)×109/L。三组组间水平比较差异具有统计学意义(P<0.05);两两比较,细菌感染组水平高于病毒感染组与对照组患儿,差异具有统计学意义(P<0.05);且病毒感染组水平高于对照组,差异有统计学意义(P<0.05)。细菌感染组中:PCT敏感度为82.80%,特异度为91.40%,CRP敏感度为69.80%,特异度为46.30%,WBC敏感度为40.20%,特异度为34.60%;病毒感染组中:PCT敏感度为59.70%,特异度为71.60%,WBC敏感度为39.50%,特异度为31.30%,联合诊断敏感度为16.90%,特异度为21.40%。结论采用降钙素原联合C-反应蛋白、白细胞诊断新生儿感染性肺炎具有良好的敏感度、特异度,能有效帮助医生确切诊断细菌性感染或病毒性感染,在临床上值得推广应用。

Objective To study the clinical effect of procalcitonin（ PCT） combined with C-reactive protein（ CBP）,white blood cell count（ WBC） on diagnosis of neonatal pneumonia infection. Methods The 110 cases of infectious pneumonia in the Sixth People＇s Hospital of Nanhai Distract from July 2012 to July 2014 were selected as the observation group,including 55 cases of children with bacterial infections and viral infections in 55 cases of children. Randomly selected 55 cases without any neonatal infectious disease as the control group,extracted venous blood and the levels of procalcitonin,C-reactive protein,white blood cells count were detected,and PCT,CBP,WBC were compared levels. Results The PCT level in children with bacterial infection was（ 0. 81 ± 0. 25） ng / ml,CRP level was（ 22. 53 ± 3. 28） mg / L,WBC level was（ 16. 86 ± 2. 63） × 10^9/ L,children with viral infections PCT level was（ 0. 57 ± 0. 37） ng / ml,CRP level was（ 9. 35 ± 2. 63） mg / L,WBC level was（ 10. 51 ± 2. 45） ×10^9/ L,PCT level in the control group was（ 0. 31 ± 0. 34） ng / ml,CRP level was（ 5. 23 ± 2. 21） mg / L,WBC level was（ 6. 53 ±2. 41） × 10^9/ L. There were significant differences among the three groups（ P〈0. 05）. The levels in bacterial infection group were higher than those in viral intecdtion and the control group,the differences were significant（ P〈0. 05）; and the viral infection group were higher than those in control group,the differences were significant（ P〈0. 05）. Bacterial infection group： PCT sensitivity was 82. 80% and specificity was 91. 40%,CRP sensitivity was 69. 80% and specificity was 46. 30%,WBC sensitivity was 40. 20% and specificity was 34. 60%; virus group： PCT sensitivity was 59. 70% and specificity was 71. 60%,WBC sensitivity was 39. 50% and specificity was 31. 30%, joint diagnostic sensitivity was 16. 90% and specificity was 21. 40%.Conclusion The use of procalcitonin joint C-reactive protein,white blood cell diagnosis of neonatal pneumonia has good sensitivity,specificity,and can effectively help doctors diagnose the exact bacterial infection or viral infection,so it should be widely applied in clinical practice.