血清PCT、hs-CRP水平及白细胞计数在新生儿感染中动态变化及其临床意义

Dynamic change of PCT,hs-CRP and WBC count in neonatal infection and its clinical significance

目的探讨降钙素原(PCT)、超敏C反应蛋白(hs-CRP)在新生儿感染中变化及其临床意义。方法选取2013年8月至2014年7月该院收治的感染新生患儿176例,所有患儿均给予抗感染、吸氧等常规治疗,按其治疗后20d的疗效分为改善组89例,无变化组48例和恶化组39例,采用酶联免疫吸附法检测治疗前(T0)、开始治疗后5d(T_1)、10d(T_2)、15d(T_3)、20d(T4)的血清PCT、hs-CRP水平。结果治疗前,三组患儿的PCT、hs-CRP及白细胞计数均无明显差异(P>0.05)。治疗后,改善组患儿的PCT、hs-CRP呈明显的下降,其中在T4达到最低(P<0.05),而恶化组患儿的PCT、hs-CRP则呈明显的上升趋势,其中在T4达到最高(P<0.05),无变化组患儿PCT、hs-CRP则无明显变化(P>0.05),在白细胞计数方面,所有患儿的白细胞计数均呈现先上升后下降的趋势,在T4时,改善组患儿的白细胞计数低于治疗前(P<0.05),恶化组患儿的白细胞计数高于治疗前(P<0.05),无变化组患儿白细胞计数与治疗前无显著差异(P>0.05)。治疗后,Spearman分析结果显示,新生患儿血清中PCT、hs-CRP和白细胞计数水平与疗效呈负相关(r_1=-0.764,P_1<0.05;r_2=-0.724,P_2<0.05;r_3=-0.573,P_3<0.05)。结论 PCT、hsCRP可有效反映感染新生患儿的治疗效果,并与患儿自身的免疫状态密切相关,可作为制定治疗方案及评估预后的参考指标之一,值得临床作进一步推广。

Objective To investigate the dynamic change of procalcitonin（PCT）and hypersensitive C-reactive protein（hs-CRP）in neonatal infection and its clinical significance.Methods 176 neonates with infection in our hospital from August 2013 to July2014were selected and treated by the routine therapy of anti-infection,oxygen inhalation,etc.,and divided into the improvement group（89cases）,non-change group（48cases）and deterioration group（39cases）according to the curative effect after 20 dtherapy.Serum PCT and hs-CRP levels were detected before treatment（T0）,on 5d（T_1）,10d（T_2）,15d（T_3）and 20d（T4）of treatment by adopting the enzyme linked immunosorbent assay（ELISA）.Results The PCT,hs-CRP levels and WBC count before treatment had no significant difference among 3groups（P〉0.05）;the PCT and hs-CRP levels after treatment in the improvement group showed the significantly declining trend,which reached the lowest at T4（P〈0.05）,while the PCT and hs-CRP levels in the deterioration group showed the obviously rising trend,which reached the highest at T4（P〈0.05）,but which in the non-change group had no significant change（P〉0.05）.In terms of WBC count,the WBC count in all the cases showed a rising first and then decreasing trend,the WBC count at T4 in the improvement group was lower than before treatment（P〈0.05）,while which in the deterioration group was higher than before treatment（P〈0.05）,but which in the non-change group had no significant change between before and after treatment（P〈0.05）;the Spearman analysis results after treatment showed that the serum PCT,hs-CRP levels and WBC count were negatively correlated with efficacy（r_1=-0.764,P_10.05;r_2=-0.724,P_20.05;r_3=-0.573,P_30.05）.Conclusion PCT and hs-CRP can effectively reflect the therapeutic effect of neonatal infection,and is closely correlated with the patient′s own immune status,which can be taken as one of reference indicators for formulating the treatment scheme and evaluating prognosis,and is worth for further clinical promotion.