降钙素原和C反应蛋白在新生儿败血症早期诊断中的价值

The clinical value of procalcitonin and C reactive protein in early diagnosis neonatal sepsis

目的探讨降钙素原(PCT)和C反应蛋白(CRP)检测在新生儿败血症早期诊断中的临床价值。方法选取2015年1月~2016年12月入住南京儿童医院滁州分院的113例新生儿作为研究对象,按照新生儿败血症的诊断标准及是否发生感染,将患儿分为败血症组(91例)和非感染组(22例)。比较败血症组与非感染组新生儿的CRP和PCT水平,比较32例败血症患儿治疗前后的PCT水平,分析CRP和PCT在诊断新生儿败血症中的敏感度、特异性、阳性预测值及阴性预测值。结果败血症组患儿的CRP、PCT水平高于非感染组,差异均有统计学意义(P<0.05)。败血症组32例患儿治疗后的PCT水平显著低于治疗前,差异有统计学意义(P<0.01)。PCT≥2μg/L诊断新生儿败血症的敏感度为74.74%,特异性为100.00%,CRP≥8 mg/L诊断新生儿败血症的敏感度为54.95%,特异性为81.82%。结论降钙素原和C反应蛋白的检测在新生儿败血症早期诊断及疗效评价中具有一定的临床价值,联合检测降钙素原和C反应蛋白有助于提高诊断的敏感度和特异度。

Objective To explore the clinical value of dection procalcitonin （CRP） and C reactive protein （PCT） in early diagnosis neonatal sepsis.Methods 113 newborn cases were collected in Chuzhou branch of Nanjing children＇s hospital from January 2015 to December 2016 and were selected as the research objects and divided into the sepsis group （91 cases） and non-infected group （22 cases） according to the diagnostic criteria for neonatal septicemia and whether in- fection was occurred.The levels of PCT and CRP between the sepsis group and non-infected group were compared,the levels of PCT of 32 children in the sepsis group before and after treatment were compared,the sensitivity, specificity, positive predictive value and negative predictive value of PCT and CRP in the diagnosis of neonatal sepsis were analyzed.Results The levels of the PCT and CRP in the sepsis group were higher than those in the non-infected group,and the differences were statistically significant （P〈0.05）.The PCT level of 32 children with septicemia after treament was significantly lower than before treatment,and the difference was statistically significant （P〈0.01）.The sensitivity of PCT≥2 μg/L to the diagnosis of neonatal sepsis was 74.74%,specificity was 100.00%,the sensitivity of CRP≥ 8 mg/L to the diagnosis of neonatal sepsis was 54.95%,and the specificity was 81.82%.Conclusion There are clinical value of detection CRP and PCT in early diagnosis neonatal sepsis and the effect of treatment.Detected PCT combine with CRP were valuable to improve sensitivity and specificity in diagnosis neonatal sepsis.