新生儿出生早期血清降钙素原浓度变化规律及其影响因素分析

Analysis of changes of procalcitionin and influencing factors on infants during the early neonatal period

目的 探讨新生儿出生早期血清降钙素原（PCT）变化规律及常见围产因素对PCT水平的影响。方法 分析2012年1月至2014年12月该院收治的无感染健康新生儿470例,其中足月儿240例,早产儿230例,分析其出生一周内血清PCT水平,采用多元线性回归分析胎龄等常见围产因素对PCT水平的影响。结果 足月儿及早产儿PCT水平在出生时极低,出生后12h内均略上升,并分别于出生后≥12~24h及≥24~48h达峰值,随后均逐步下降,最后两者分别在出生后约72h后及96h后降至正常婴儿水平。多元回归分析提示早产儿的PCT水平与样本检测时间（出生日龄）及其胎龄大小相关,足月儿PCT水平仅与出生日龄相关。结论 足月儿及早产儿在出生早期PCT生理波动规律有所不同,且早产儿胎龄与PCT水平相关,该发现对于新生儿早发细菌感染的诊断与鉴别诊断、指导临床合理使用抗菌药物有重要临床意义。

Objective To investigate changes of procalcitionin （PCT ） and influencing factors on infants during the early neonatal period .Methods A total of 470 healthy neonates including 240 term newborns and 230 preterm newborns were enrolled from Janu-ary 2012 to December 2014 .And the level of PCT between birth and the first week of life was analyzed .Gestational age and other common perinatal variables were investigated to see how the factors influenced PCT concentration by multivariable analysis . Results Levels of PCT were lowest at birth in term and preterm newborns and then increased slightly within 12 h after birth , which gradually reached the peak values at ≥ 12 - 24 h and ≥ 24 - 48 h after birth ,and then declined slowly to normal levels at 72 h and 96 h after birth .respectively in multivariable analysis ,gestational age and neonatal age influenced PCT concentration inde-pendently in preterm newborns ,and only neonatal age was associated with PCT values in term newborns .Conclusion There are dif-ferent changing rules of PCT level in term and preterm babies during the early neonatal period ,and gestation age is related with PCT concentration in preterm babies .The findings are helpful in detecting early-onset neonatal bacterial infection and rational use of antibiotics in clinic .