降钙素原变化率对新生儿肺部感染的预测价值

Predictive value of the change rate of procalcitonin for pulmonary infection in neonates

目的分析降钙素原变化率对肺部感染的新生儿的预测价值,为早期识别危重新生儿提供依据。方法收集2018年7月-2019年8月期间于深圳市宝安区妇幼保健院出生的且并发肺部感染的新生儿,共计400例,检测所有新生儿入院时和24 h时的降钙素原的水平,并计算比较所有新生儿降钙素原的变化率,根据新生儿的降钙素原变化率[(入院24 h时降钙素原-入院时降钙素原)/入院时降钙素原]将其分为对照组(≤0.00%)和观察组(>0.00%)各200例。同时检测两组新生儿体内的C反应蛋白和维生素A的含量,然后比较C反应蛋白、维生素A和降钙素原变化率对新生儿肺部感染的预测价值。结果与对照组相比,观察组新生儿体内的C反应蛋白含量明显降低(t=-30.601),维生素A含量增加(t=-15.460),住院时间明显延长(t=13.783);脓毒症发生率显著增加(χ^2=4.712,P<0.05)。此外,降钙素原变化率诊断肺部感染新生儿并发脓毒症的曲线下面积为0.821(95%CI:0.803~0.878,P<0.05),较C反应蛋白和维生素A更具检测价值。结论降钙素原变化率对新生儿肺部感染具有预测价值,临床可推广应用。

Objective To analyze the predictive value of the change rate of procalcitonin for pulmonary infection in neonates,so as to provide basis for early identification of critical newborns. Methods A total of 400 newborns complicated with pulmonary infection in Shenzhen Baoan District Maternal and Child Health Hospital were enrolled in this study from July 2018 to August 2019.The levels of procalcitonin at admission and 24 hours later were measured and compared.The change rate of procalcitonin in children was calculated[(procalcitonin at admission at 24 h-procalcitonin at admission)/procalcitonin at admission].According to the change rate of procalcitonin,all children were divided into control group(change rate of procalcitonin≤0.00%) and observation group(change rate of procalcitonin>0.00%),with 200 cases in each group.The levels of C-reactive protein(CRP) and vitamin A in the two groups of neonates were tested,and then the predictive value of C-reactive protein,vitamin A and procalcitonin rate in neonates with pulmonary infection were compared. Results Compared with the control group,the C-reactive protein content in the neonates was significantly lower(t=-30.601),while the vitamin A content was significantly higher(t=-15.460) in the observation group.Furthermore,the length of stay was significantly longer(t=13.783) and the incidence of sepsis was significantly higher(χ^2=4.712,P<0.05) in the observation group.In addition,the area under the curve of procalcitonin change rate in diagnosing of pulmonary infection complicated with sepsis in newborns was 0.821(95%CI:0.803-0.878,P<0.05),which was higher than that of C-reactive protein and vitamin A. Conclusion The change rate of procalcitonin has a significant predictive value for neonatal pulmonary infection.