WBC/hsCRP/PCT在新生儿感染性疾病早期诊断中的价值

The value of WBC,hsCRP and PCT in the early diagnosis of neonatal infectious diseases

目的探讨白细胞计数(WBC)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)在新生儿细菌性感染中的应用价值。方法选取2012年1月至2014年1月本院儿科病房收治的128例感染性疾病新生儿为研究对象,根据患儿感染类型分为细菌性感染68例及病毒性感染60例,另选取60例非感染性疾病新生儿为对照组,应用电化学发光法测定三组患儿血清PCT,免疫荧光定量法测定hs-CRP,XE-2100血液计数仪测定WBC。结果细菌感染组患儿血清WBC、PCT、hs-CRP水平及阳性率显著高于病毒感染组及对照组(P<0.05)。与入院时相比,细菌感染组患儿入院24h内WBC、PCT、hs-CRP水平达到高峰,并于入院后第3d下降,入院第5d后恢复至正常水平。与单一指标检测相比,联合检测的灵敏性、准确性、特异性显著较高,差异有统计学意义(P<0.05)。结论血清WBC、PCT、hs-CRP水平可作为新生儿早期细菌性感染的监测指标,且联合诊断可提高诊断灵敏性及特异性。

Objective To investigate value of the white blood cell count （WBC）, procalcitonin （PCT）, high-sensi- tivity C-reactive protein （hs-CRP） in neonatal bacterial infection. Methods 128 patients of infectious diseases were bac- terial infection in children infected （n= 68）and viral infection （n=60）. 60 cases of Non-infectious diseases newborn were selected the control group. The levels of PCT, hs-CRP of three groups were measured by radioimmunoassay and the lev- els of WBC were measured with SEg000 blood semi-quantitative immune chromatography. Results The levels of serum WBC, PCT, hs-CRP and the positive rate were significantly higher than the viral infection group and the control group （P〈0.05）. The levlels of WBC, PCT, hs-CRP within 24h bacterial infection in children admitted and declined in the first 3d after admission, returned to normal levels after admission 5d. Compared with the single index detection, com- bined detection sensitivity, accuracy, specificity was significantly higher, the difference was statistically significant （P〈 0.05）. Conclusion Serum WBC, PCT, hs-CRP levels can be used as early neonatal bacterial infections monitoring indi- cators, and the combined diagnosis can improve the diagnostic sensitivity and specificity.