在足月新生儿ABO溶血病中CRP与PCT的表达特征及治疗指导意义

CRP and PCT Expression Characteristics and Therapeutic Implications in ABO Hemolytic Disease of Term Neonates

目的分析在足月新生儿ABO溶血病中CRP(C反应蛋白)和PCT(降钙素原)的表达特征以及临床指导意义。方法随机选取2019年2月至2021年2月珠海市香洲区人民医院收治的40例足月新生儿ABO溶血病患者为A组,并随机选取同期未发生溶血的足月新生儿40例为B组。均在入院后第1d和第3d进行CRP和PCT检测,分析其值的变化、诊断效能、抗菌药物使用及入院3d内感染发生情况。结果同B组新生儿相比,A组患儿入院后第1d、第3d CRP和PCT值均显著较高(P<0.05);PCT诊断灵敏度、特异度、准确度分别为96.25%、95.00%、97.50%,显著高于CRP诊断效能86.25%、80.00%、82.50%(P<0.05);A组患儿抗菌药物使用率为10.00%,B组抗菌药物使用率为2.50%,B组抗菌使用率显著降低(P<0.05),两组研究对象入院3d内感染发生率无统计学意义(P>0.05)。结论足月新生儿ABO溶血病患儿免疫性溶血反应可能导致CRP、PCT值均偏高,但其感染发生率与非溶血性新生儿黄疸患儿并无差异,值得临床借鉴。

Objective To analyze the expression characteristics and clinical significance of CRP(C-reactive protein) and PCT( procalcitonin) in term neonatal ABO hemolytic disease. Methods Randomly 40 patients with fullterm neonatal ABO hemolytic disease were selected from February 2019 to February 2021 in Xiangzhou District People’s Hospital of Zhuhai as A group, and randomly 40 full-term newborns without hemolysis were selected as B group. CRP and PCT were tested on the 1 st and 3 rd day after admission to analyze the changes in their values, diagnostic efficacy, use of antibacterial drugs and the occurrence of infections within 3 days of admission. Results Compared with B group of newborns, A group had significantly higher CRP and PCT the 1 st and 3 rd day after admission(P<0.05);The diagnostic sensitivity, specificity, and accuracy of PCT were 96.25%, 95.00%, and 97.50%, respectively, which were significantly higher than the diagnostic efficiency of CRP by 86.25%, 80.00%, and 82.50%(P<0.05). Antimicrobial use rate was 10.00% in A group, 2.50% in B group. The antimicrobial use rate in B group decreased significantly(P<0.05). There was no significant incidence of infection within 3 d of admission(P>0.05). Conclusion The immune hemolysis reaction in children with term neonatal ABO hemolytic disease may lead to high CRP、PCT value, but the incidence of infection is not different from that in children with non-hemolytic neonatal jaundice, which is worthy of clinical reference.