出生6小时内C反应蛋白和降钙素原在新生儿早发型败血症中的诊断价值探讨

Diagnostic value of C-reactive protein and procalcitonin in 6 hours after birth for diagnosis of earlyonset neonatal sepsis

目的探讨C反应蛋白(CRP)和降钙素原(PCT)在出生6 h内新生儿早发型败血症中的诊断价值。方法选取48例出生6 h内新生儿早发型败血症患儿为实验组,同期出生的48例健康新生儿作为对照组。比较两组新生儿的CRP及PCT检测结果,采用受试者工作特征曲线(ROC)评估CRP及PCT的诊断价值。结果实验组CRP及PCT水平分别为(8.74±6.54)mg/L、(8.51±7.03)ng/ml,均明显高于对照组的(4.36±3.21)mg/L、(1.04±0.54)ng/ml,差异均有统计学意义(P<0.05)。CRP曲线下面积为0.73,截断值为2.57 mg/L,灵敏度为79.12%,特异度为55.34%;PCT曲线下面积为0.87,截断值为3.01 ng/ml,灵敏度为58.42%,特异度为93.54%;CRP+PCT曲线下面积为0.951,灵敏度为88.41%,特异度为92.41%。结论对于新生儿早发型败血症的诊断,开展血清CRP及PCT检测具有极为重要的临床意义,且联合检测的灵敏度、特异度及正确率更高,诊断价值最大,可以在临床诊疗工作中进一步推广运用。

Objective To discuss the diagnostic value of C-reactive protein(CRP)and procalcitonin(PCT)in 6 hours after birth for diagnosis of early-onset neonatal sepsis.Methods There were 48 cases of earlyonset neonatal sepsis septicemia within 6 h of birth selected as the experimental group,and 48 healthy newborns as the control group.The CRP and PCT test results of the two groups were compared,and the diagnostic value of CRP and PCT was evaluated by receiver operation characteristic(ROC)curve.Results The levels of CRP and PCT of the experimental group were(8.74±6.54)mg/L and(8.51±7.03)ng/ml respectively,which were obviously higher than those of the control group(4.36±3.21)mg/L and(1.04±0.54)ng/ml,and the difference was statistically significant(P<0.05).In the experimental group,the area under the CRP curve of was 0.73,the optimal diagnostic threshold was 2.57 mg/L,the sensitivity was 79.12%,the specificity was 55.34%,and the accuracy rate was 67.41%;the area under the PCT curve was 0.87,the optimal diagnostic threshold was 3.01 ng/ml,and the sensitivity 58.42%,the specificity was 93.54%,and the accuracy rate was 74.95%;the area under the CRP+PCT combined diagnosis curve was 0.951,the sensitivity was 88.41%,the specificity was 92.41%,and the accuracy rate was 91.08%.Conclusion The detection of serum CRP and PCT is of great clinical significance for the diagnosis of early-onset neonatal sepsis,and the combined detection has higher sensitivity,specificity and accuracy.This method can be further promoted and applied in clinical diagnosis.