非感染因素对早产新生儿血清降钙素原浓度的影响

The effect of non-infectious diseases on serum procalcitonin concentrations in premature neonates

目的研究非感染因素对早产新生儿血清降钙素原的影响。方法选择北京军区总医院附属八一儿童医院早产儿重症监护中心2012年1月至2012年12月期间收治入院的胎龄为33~36周、出生时间小于12小时、无胎膜早破因素的非感染性疾病早产儿为研究对象。所有患儿入院后即采血进行血常规、C反应蛋白、血培养及降钙素原检查。非感染性疾病患儿包括新生儿颅内出血(ICH)、新生儿呼吸窘迫综合征(NRDS)、新生儿窒息及对照组单纯早产儿。动态监测各组患儿血常规、C反应蛋白、血培养、降钙素原等指标,并比较各组患儿降钙素原浓度,通过统计分析各组早产新生儿的血清降钙素原浓度,以研究不同非感染性疾病对其血清降钙素原浓度的影响。结果 1同目前文献推荐的血清降钙素原浓度(<0.5 ng/ml)相比,早产新生儿生后血清降钙素原浓度有生理性升高(1.07±0.76)ng/ml。2 ICH组(2.12±0.99)ng/ml、NRDS组(2.28±1.09)ng/ml、新生儿窒息组(3.64±3.17)ng/ml降钙素原水平较对照组(1.07±0.76)ng/ml均升高(F=10.462,P<0.05)。不同程度的ICH间降钙素原差异无显著性(F=0.173,P=0.950);Ⅱ级、Ⅲ级NRDS降钙素原水平较Ⅰ级NRDS升高(F=5.475,P=0.010);重度窒息组降钙素原水平较轻度窒息组明显升高(t=5.245,P=0.003)。结论早产儿生后降钙素原浓度有生理性升高。降钙素原受多种因素影响,ICH、NRDS、新生儿窒息可导致早产新生儿降钙素原浓度升高,在早产新生儿中不能单纯依靠降钙素原水平评价早产儿感染情况。

Objective To study the effect of non-infectious factors on serum procalcitonin(PCT) in preterm neonates.MethodThe premature infants of neonatal intensive care unit(NICU) in our hospital were chosen from gestational age ranged from 33 to 36 weeks, birth time less than 12 hours without premature rupture and hospitalization period from January 2012 to December 2012. All of the premature infants were <br> drawn blood immediately admitted to hospital and C-reactive protein (CRP), blood cultures and procalcitonin were tested. The types of premature infants non-infectious diseases included intracranial hemorrhage (ICH), neonatal respiratory distress syndrome (NRDS), neonatal asphyxia and the control group (preterm infants) without disease. The blood routine , C-reactive protein, blood culture, procalcitonin and other infections indicators in each group were monitored dynamicly in order to study the impact of these non-infectious diseases on serum procalcitonin concentrations by statistical analysis.Results ① Compared with the current literature recommended serum procalcitonin concentrations (<0.5ng / ml), procalcitonin concentrations in preterm neonates singniifcantly increase (1.07± 0.76) ng / ml.②Compared with control group (1.07±0.76) ng/ml,the procalcitonin levels in intracranial hemorrhage group (2.12± 0.99) ng/ml, neonatal respiratory distress syndrome group (2.28±1.09) ng/ml and asphyxia group (3.64± 3.17) ng / ml signiifcantly increased (F= 10.462,P <0.05).There were no signiifcant differences (F= 0.173,P= 0.950) among the different levels of intracranial hemorrhage group; Compared with the ifrst grade NRDS , the procalcitonin leves in second grade and third grade NRDS groups were significantly increased (F=5.475,P= 0.010); The procalciton level in severe asphyxia group was signiifcantly higher than in mild asphyxia group (t= 5.245,P= 0.003). Conclusions The procalcitonin concentration physiologically increased after preterm neonates were born. Many factors such as intracranial hemorrhage, neonatal respiratory distress syndrome and neonatal asphyxia can increase procalcitonin concentration so the level of PCT levels can not evaluate accurately preterm children infection.