血清降钙素原测定在新生儿感染性疾病诊断中的应用

Application of PCT measurement in diagnosis of newborn infectious diseases

目的了解降钙素原(PCT)在新生儿感染性疾病中的诊断价值。方法选取2013年1—8月该院210例新生儿作为研究对象,根据临床表现分为严重感染组36例,局部感染组14例和非感染组160例,分别于入院后、病情变化时检测PCT、血常规、超敏C反应蛋白(hs-CRP),进行血培养。结果 3组新生儿按PCT水平进行两两比较,差异有统计学意义(P<0.05);不同疾病患儿按PCT水平进行两两比较,差异有统计学意义(P<0.05);在上呼吸机、CPAP患者中,PCT检验结果优于血常规、hs-CRP和血培养,差异均有统计学意义(P<0.05)。结论 PCT能大致区分细菌感染与非细菌感染,并有着高于其他同类炎性指标的灵敏度,能早期快速反映病情发展。通过PCT值的动态变化来判断病情与预后,可早期识别和治疗可能发展为脓毒症的高危患儿。同时,PCT可指导新生儿抗菌药物的使用,大大减少抗菌药物的滥用。

Objective To understand the values of procalcitonin（PCT） in the diagnosis of newborn infectious diseases. Methods 210 newborns in this hospital from Jan.to Aug.2013 were selected as the study subjects and divided into the severe infection group （36 cases）, local infection group （ 14 cases and ono-infection group （ 160 cases ） according to the clinical manifestations.The PCT level, blood routine and hs-CRP level were detected at admission and disease condition change.Meanwhile the blood culture was perfoi^led.Results The pairwise comparison among 3 groups was performed according to the PCT level, and the difference was statistically significant （P〈0.05） ;the pairwise comparison among the patients with different diseases according to the PCT level, and the difference was statistically significant （P〈0.05） ;in the patients with respirator and continuous positive airway pressure, the results of PCT detection was superior to those of blood routine, hs-CRP and blood culture, and the difference was statistically significant （P〈0.05）. Conclusion PCT can roughly distinguish the bacterial infection fi＇om non- bacterial infection and has the higher sensitivity than other inflammatory indicators, can rapidly reflect the disease condition development at early stage.Judging the disease condition and prognosis by the dynamic change of PCT value can early recognize and treat the high risk newborn patients possibly developing into sepsis.Meanwhile PCT can guide the use of bacterial drugs in newborn patients ,which can greatly decrease the abuse of antiseptic drugs.