血清PCT与hs-CRP对低出生体重儿高胆红素血症并发感染的联合诊断效果研究

Combined diagnostic effect of serum PCT and hs-CRP on infection in low-birth-weight newborns with hyperbilirubinemia

目的探讨血清降钙素原(PCT)与超敏C-反应蛋白(hs-CRP)对低出生体重儿高胆红素血症并发感染的联合诊断效果。方法选取医院2016年1月-2017年12月收治的高胆红素血症低出生体重新生儿136例为研究对象,根据是否合并感染将患儿分为感染组(n=46)和非感染组(n=90)。于出生后第1天清晨无菌采集空腹股静脉血,采用双抗体夹心法检测血清PCT水平,采用胶乳凝集反应法检测血清hs-CRP水平。结果感染组血清PCT(1.38±0.75)ng/mL和hs-CRP(12.36±4.15)mg/L水平均高于未感染组的(0.37±0.16)ng/ml和(2.67±1.36)mg/L(P<0.05);ROC曲线分析结果显示,血清PCT和hs-CRP对低出生体重新生儿高胆红素血症并发感染的曲线下面积分别为0.918和0.824,其最佳截断值分别为0.21ng/ml和1.18mg/L,PCT对应的诊断灵敏度为91.88%和特异度为85.20%,hs-CRP对应的诊断灵敏度为90.35%和特异度为81.20%,PCT联合hs-CRP诊断灵敏度为97.88%和特异度为92.20%。结论血清PCT和hs-CRP可用于诊断高胆红素血症低出生体重儿合并感染,且联合检测PCT和hs-CRP在诊断感染时具有高的准确性和灵敏性,比单独检测更具优势。

OBJECTIVE To investigate the combined effect of serum procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) in the diagnosis of infection in low-birth-w&ght newborns with hyperbilirubinemia. METHODS One hundred and thirty-six patients with hyperbilirubinemia and low birth weight who were admitted to our hospital from Jan. 2016 to Dec. 2017 were selected as the study subjects. They were divided into the infection group (n =46) and the non-infection group (n = 90) according to the occurrence of co-infection. At the first day after birth, fasting femoral vein blood was aseptically collected. The serum PCT level was detected by double antibody sandwich method. The serum hs-CRP level was detected by latex agglutination reaction method. RESULTS The levels of serum PCT (1.38 ± 0.75) ng/ml and hs-CRP (12.36 ± 4.15) mg/L in the infection group were significantly higher than those in the uninfected group which were (0.37±0.16) ng/ml and (2.67 ± 1.36) mg/L (P<0.05). The ROC curve analysis showed that the area under the curve of serum PCT and hs-CRP in low-birth-weight neonatal hyperbilirubinemia complicated by infection was 0.918 and 0.824, respectively. The optimal cutoff values were 0.21 ng/ml and 1.18 mg/L, respectively.PCT had a diagnostic sensitivity of 91.88% and a specificity of 85.20%. The diagnostic sensitivity of hs-CRP was 90.35% and the specificity was 81.20%. The diagnostic sensitivity of PCT combined with hs-CRP was 97.88% and the specificity was 92.20%. CONCLUSION Serum PCT and hs-CRP can be used for the diagnosis of co-infection of low-birth-weight infants with hyperbilirubinemia, and the combined detection of PCT and hs-CRP has high accuracy and sensitivity in the diagnosis of infec-tion, which is more advantageous than single detection.