降钙素原和C反应蛋白联合检测在新生儿感染性疾病诊断中的应用评估

Combined detection of procalcitonin and C-reactive protein for diagnosis of neonatal infectious disease

目的 :探讨降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)联合检测对于各类新生儿感染性疾病的临床诊断价值。方法:选取我院同时进行PCT和CRP检测的新生儿,其中血流感染24例,肺炎27例(肺炎组),并选取排除血流感染和肺部感染的健康新生儿28例作为正常对照组。检测感染性疾病患儿和健康新生儿的PCT和CRP水平。通过诊断试验四格表分别计算灵敏度、特异度、阳性预测值和阴性预测值。结果:正常对照组的PCT和CRP水平分别为(0.48±0.01)ng/m L、(1.17±0.09)mg/L,血流感染组分别为(1.51±0.57)ng/m L、(8.98±2.64)mg/L,肺炎组分别为(0.87±0.27)ng/m L、(6.67±1.67)mg/L。后两组的PCT、CRP水平均明显高于正常对照组的检测结果,差异有统计学意义(P<0.05)。在血流感染和肺部感染时,单独检测PCT、CRP及两者联合检测的特异度均为82.1%、92.9%和96.4%。结论 :PCT和CRP检测对于新生儿感染有重要的临床诊断价值,尤其在血流感染和肺部感染时,联合检测PCT和CRP的特异度较高,检测低值能快捷、有效地排除新生儿感染。

Objective To investigate the value of combined detection of procalcitonin （PCT） and C-reactive protein （CRP） for diagnosis of neonatal infectious disease. Methods Newborn infants undergoing combined detection of PCT and CRP were enrolled, including 24 cases with blood stream infection and 27 cases of pneumonia infection, and 28 healthy newborns were served as controls. Levels of PCT and CRP were measured, and sensitivity, specificity, positive predictive value and negative predictive value were calculated by the diagnostic four fold table. Results Levels of PCT in controls, blood stream infection group and pneumonia infection group were （0.48±0.01） ng/mL, （1.51±0.57） ng/mL and （0.87±0.27）ng/mL, respectively; and CRP were （1.17±0.09） nag/L, （8.95±2.64） mg/L, and （6.67±1.67） mg/L, respectively.Levels of PCT and CRP in infants with infectious diseases were significantly higher than those in controls（P〈0.05）. The specificity of PCT, CRP, and combined PCT and CRP detection for diagnosing blood stream infection and pneumonia infection were 82.1%, 92.9% and 96.4%, respectively. Conclusions Detections of PCT and CRP have important value for diagnosis of neonatal infections, especially for blood stream infection and pneumonia infection, and combined detection of PCT and CRP has higher specificity.