PCT,IL-6及CRP对新生儿宫内细菌感染的诊断价值

Value of PCT, IL-6 and CRP in Diagnosis of Neonatal Intrauterine Bacterial Infection

目的:探讨降钙素原(PCT)、白细胞介素-6(IL-6)及C反应蛋白(CRP)对新生儿宫内细菌感染的诊断价值。方法:根据感染结局将2013年3月-2014年9月在我院分娩且有宫内感染高危因素的179例新生儿分为感染组(34例)和无感染组(145例),检测两组新生儿的PCT、IL-6及CRP水平,并比较其对宫内细菌感染的诊断价值。结果:感染组新生儿脐带血PCT、IL-6、CRP水平均高于无感染组,差异有统计学意义(P<0.05)。感染组新生儿各单个指标阳性率、两指标联合检测阳性率高于无感染组,差异均有统计学意义(P<0.05),感染组新生儿PCT、IL-6阳性率高于CRP,PCT+IL-6的阳性率高于PCT+CRP、IL-6+CRP,差异均有统计学意义(P<0.05)。PCT+IL-6的灵敏度、准确率高于单个指标及其他两个指标联合检测,差异均有统计学意义(P<0.05),各项指标检测的特异性比较,差异无统计学意义(P>0.05)。结论:新生儿宫内感染采用脐带血PCT检测具有灵敏度高、特异性好的特点,联合IL-6检测是临床诊断新生儿宫内感染的有效方式。

Objective： To explore the diagnosis value of procalcitonin（PCT）, interleukin-6（IL-6）and C reactive protein（CRP） for neonatal intrauterine bacterial infection. Methods： A total of 179 newborn infants with high risk factors of intrauterine infection, who were born in 3201 hospital of China Aviation Industry from March 2013 to September 2014, were divided into infection group（34 infants） and non-infection group（145 infants） according to the outcome. The PCT, IL-6, CRP levels of the two groups were detected and their values were compared in the diagnosis of intrauterine bacterial infection. Results： The PCT, IL-6 and CRP levels in the umbilical cord blood of newborn infants in the infection group were higher than those in the non-infection group, the difference was statistically significant（P〈0.05）. The positive infection rates of each single index and two indicators of combination detection in the infection group were higher than those in the non-infection group, the difference was statistically significant（P〈0.05）. In infection group, positive infection rates of PCT and IL-6 were higher than that of CRP respectively; and the positive infection rate of PCT combined with IL-6 was higher than that of PCT combined with CRP, IL-6 combined with CRP respectively, the difference was statistically significant（P〈0.05）.There was no statistically significance in the sensitivity and accuracy of detection of each index（P〉0.05）. Conclusion： Detecting the level of PCT in the umbilical cord blood has advantages of high sensitivity and good specificity, and combination detection of PCT plus IL-6 is the most effective way to diagnose neonatal intrauterine bacterial infection in the clinical application. to diagnostic neonatal intrauterine bacterial infection which was once it combined with IL-6.