血清降钙素原、C-反应蛋白在新生儿感染的临床应用

Clinical application of serum procalcitonin and C-reactive protein in neonatal infection

目的探讨血清降钙素原(PCT)、C-反应蛋白(CRP)在新生儿感染性疾病中的临床应用及临床价值。方法 2014年1月至2014年12月乐清市妇幼保健院收治的120例感染性疾病患儿(47例重症感染伴全身症状新生儿、73例局部感染无全身症状新生儿),以及40例非感染性疾病新生儿,根据细菌培养、血清学检验,将120例感染性疾病患儿分为细菌感染组(76例)、非细菌感染组(44例),检测和比较各组血清PCT、CRP水平。结果与非感染组相比,重症感染组、局部感染组的血清CRP、PCT浓度均明显升高(CRP:t=8.93、t=6.17;PCT:t=7.24、t=5.31;均P<0.05)。与局部感染组相比,重症感染组血清CRP、PCT浓度均明显升高(CRP:t=4.29;PCT:t=5.47;均P<0.05)。与非细菌感染组相比,治疗前细菌感染组血清CRP、PCT浓度均明显升高(CRP:t=8.49;PCT:t=7.14;均P<0.05);与治疗前相比,治疗后细菌感染组血清CRP、PCT浓度明显降低(CRP:t=7.61;PCT:t=6.38;均P<0.05)。与白细胞计数检测相比,CRP、PCT检测的敏感度、特异度均明显增高(CRP:t_(敏感度)=12.90、t_(特异度)=33.97;PCT:t_(敏感度)=20.95、t_(特异度)=50.42;均P<0.05)。结论 CRP、PCT检测为新生儿感染性疾病的早期诊断及预后评估,提供了快速的病原学诊断依据,动态观察感染程度及感染控制情况。

Objective To study the clinical application and clinical value of serum procalcitonin （ PCT） and C-reactive protein （ CRP） in neonatal infection.Methods From January to December 2014 totally 120 cases of infectious disease including 47 neonates with severe infection combining systemic symptoms （ severe infection group ） and 73 neonates with local infection without systemic symptoms （ local infection group） were admitted in Maternal and Child Health Care Hospital in Yueqing City.They were divided into bacterial infection group （76 cases） and non-bacterial infection group （44 cases）.The serum PCT and CRP levels were detected and compared among different groups.Results Compared with non-bacterial infection group, the serum CRP and PCT levels were significantly increased in severe infection group and local infection group （CRP：t=8.93,t=6.17;PCT：t=7.24,t=5.31, respectively, all P〈0.05）.The serum CRP and PCT levels in severe infection group were significantly increased compared with local infection group （tCRP =4.29;tPCT =5.47, respectively, both P〈0.05）.Compared to non-bacterial infection group, the serum CRP and PCT levels in bacterial infection group were significantly increased before treatment （ tCRP =8.49;tPCT =7.14, respectively, both P〈0.05） and obviously decreased after treatment （tCRP =7.61; tPCT =6.38, respectively, both P ＆lt;0.05）.The sensitivity and specificity of CRP and PCT detection were improved significantly compared with WBC detection （CRP：tsensitivity =12.90,tspecificity =33.97, PCT：tsensitivity =20.95, tspecificity =50.42, respectively, all P ＆lt;0.05）.Conclusion The detection of CRP and PCT levels provides quick pathogenic diagnosis basis for early diagnosis and prognostic assessment of neonatal infection disease, and can dynamically observe the severity of infection and infection control.