降钙素原、C-反应蛋白及白细胞参数联合测定对新生儿败血症的早期诊断

Early Diagnosis of Neonatal Sepsis by Combined Determination of Procalcitonin,c-Reactive Protein,and Leukocyte Parameters

为研究和比较新白细胞参数平均中性粒细胞和单核细胞体积(MNV,MMV)、电导率(MNC,MMC)、散射(MNS,MMS)和VO的疗效以及新生儿败血症血清C-反应蛋白(CRP)、降钙素原(PC)和白细胞介素-6(IL-6)的LUME分布宽度(NDW,MDW)。本研究共分析了113名新生儿(66名男孩,47名女孩),其中脓毒症组有58名,对照组有55名。在诊断时收集婴儿的静脉血样,分析全血细胞计数、外周血涂片、血培养、CRP、PC、IL-6、MNV、MMV、MNC、MMC、MNS、MMS、NDW和MDW。脓毒症婴儿的MNV、NDW、MMV和MDW均高于对照组(均p<0.05)。脓毒症患者MNS较低(p=0.002)。在MNC、MMC和MMS方面,败血症组和对照组之间没有显著差异。虽然中性粒细胞和单核细胞体积、电导率、散射和体积分布宽度等白细胞参数对新生儿脓毒症的预测价值较低,但是CRP、PC、IL-6等新指标与其他筛查工具一样,对新生儿脓毒症的鉴别诊断有一定的参考价值,特别是MNV似乎是具有最高特异性的有效参数,也证实了PC在早期脓毒症诊断中的重要性。

To study and compare the effects of mean neutrophil and monocyte volume(MNV,MMV),conductivity(MNC,MMC),scattering(MNS,MMS)and VO with new leukocyte parameters,and the LUME distribution width(NDW,MDW)of serum C-reactive protein(CRP),procalcitonin(PC)and interleukin-6(IL-6)in neonatal sepsis.113 newborns(66 boys and 47 girls)were analyzed.There were 58 infants in sepsis group and 55 infants in control group.During diagnosis,venous blood samples of infants were collected to analyze the whole blood cell count,peripheral blood smear,blood culture,CRP,PC,IL-6,MNV,MMV,MNC,MMC,MNS,MMS,NDW and MDW.The levels of MNV,NDW,MMV and MDW in sepsis infants were higher than those in control group(all p<0.05).MNS was lower in sepsis patients(p=0.002).There was no significant difference between septicemia group and control group in terms of MCC,MMC and MMS.Although the white blood cell parameters such as neutrophil and monocyte volume,conductivity,scattering and volume distribution width have low predictive value for neonatal sepsis.Like other screening tools,CRP,PC,IL-6 and other new indicators have certain reference value for the differential diagnosis of neonatal sepsis.In particular,MNV seems to be the most specific and effective parameter,which also confirms the importance of PC in the diagnosis of early sepsis.