血清hs-CRP和PCT水平检测对新生儿败血症的早期诊断及疗效判断价值

Serum hs-CRP and PCT levels detection in early diagnosis and treatment evaluation of neonatal sepsis

目的探讨血清超敏C反应蛋白(hs-CRP)和降钙素原(PCT)水平检测对新生儿败血症的早期诊断及疗效判断价值。方法选择67例新生儿败血症患者为败血症组,以同期收治的新生儿局部感染患者63例为局部感染组,以无感染征象的健康新生儿65人为对照组,分别采用免疫比浊法和固相免疫色谱法测定3组血清中hs-CRP和PCT的含量。治疗前后对新生儿败血症患者进行全身性感染相关性器官功能衰竭评分(SOFA)和危重评分(PCIS)。结果败血症组血清hs-CRP和PCT水平明显高于局部感染组和对照组(P<0.05),局部感染组血清hs-CRP和PCT水平明显高于对照组(P<0.05),差异均有统计学意义。分别以hs-CRP≥10 mg/L和PCT≥2 ng/ml为阳性临界值,诊断新生儿败血症的灵敏度和特异度分别为64.27%、53.17%和87.05%、61.91%,而联合应用该两项指标则能显著提高新生儿败血症诊断的灵敏度和特异度(96.17%和72.40%)。败血症组血清PCT水平与SOFA评分呈正相关(P<0.05),与PCIS评分呈负相关(P<0.05)。结论 hs-CRP与PCT联合检测能提高新生儿败血症早期诊断价值,动态监测PCT水平有助于评估疾病的治疗效果。

Objective To explore the value of early diagnosis and curative effect judgment of procalcitonin（PCT） and highsensitivity C-reactive protein（hs-CRP） on neonatal sepsis. Methods 67 cases of patients with neonatal sepsis were chosen as the septicemia group,63 cases of patients with local infection as the local infection group and 65 cases of health newborn as the control group in this study. The levels of serum hs-CRP and PCT were detected and compared among the three groups. The PCT level was detected by electrochemiluminescence method. The hs-CRP level was detected by immune turbidimetry,and PCT level was detected by solid phase immune chromatography. The critical conditions in patients with neonatal sepsis were evaluated by using spsis-related organ failure assessment（SOFA） and pediatric critical illness scoring（PCIS）. Results The levels of serum hs-CRP and PCT in the septicemia group were significantly higher than those in local infection group and control group（P〈0.05）,and the levels of serum hs-CRP and PCT in the local infection group were significantly higher than those in the control group（P〈0.05）. Based on the positive threshold of hs-CRP ≥10 mg / L and PCT ≥2 ng / ml in the diagnosis of neonatal septicemia,the sensitivity and specificity were 64.27%,53.17% and 87.05%,61.91%,respectively,but the sensitivity and specificity of combined detection of hs-CRP and PCT in the diagnosis of neonatal septicemia was higher（96.17% and 72.40%,respectively）. Conclusion The combined detection of hs-CRP and PCT levels can improve the early diagnosis value of neonatal sepsis,Dynamic monitoring of PCT level is helpful in evaluating the clinical curative effect of neonatal sepsis.