新生儿早发型败血症血液检查指标与预后的相关性研究

Correlation between prognosis of neonates with early-onset sepsis and blood test indicators

目的探讨新生儿早发型败血症(EOS)血液检查指标与患儿短期预后的相关性。方法回顾性分析2011年至2020年本院收治的EOS病例共89例,根据临床转归分为治愈/好转组80例和死亡组9例,对两组基本特征、血液非特异性指标[白细胞计数(WBC)、中性粒细胞绝对计数(ANC)、血小板计数(PLT)、C反应蛋白(CRP)]、血液培养结果及血液培养阳性报警时间进行比较,分析其与患者短期预后的相关性。结果与治愈/好转组比较,死亡组在起病后12 h内WBC<5×10^(9)/L比例更高且WBC、ANC更低(P<0.05),死亡组在起病后12~36 h WBC<5×10^(9)/L、PLT<100×10^(9)/L的比例更高,WBC、ANC、PLT更低,CRP水平更高(P<0.05),死亡组起病后7 d内WBC<5×10^(9)/L、PLT<100×10^(9)/L比例更高,WBC、血PLT更低(P<0.05)。死亡组血培养阳性报警时间短于治愈/好转组(P<0.05)。结论新生儿EOS死亡者胎龄小、出生体重低,短期预后与血液WBC减少、PLT减少以及血液培养阳性报警时间短等相关。

Objective To investigate the correlation between blood test indicators and short-term prognosis of neonates with early-onset sepsis(EOS).Methods Eighty-nine EOS cases admitted to the hospital from 2011 to 2020 were retrospectively analyzed,and they were divided into cured/improved group(n=80)and death group(n=9)according to clinical outcome.Basic characteristics,non-specific blood indicators including WBC,absolute neutrophil count(ANC),PLT and C-reactive protein(CRP),blood culture results and the time to positivity of blood culture were compared.Results Compared with the cured/improved group,the death group had a higher incidence of WBC<5×10^(9)/L and lower WBC,ANC within 12 h after the onset of sepsis(P<0.05),Within 12-36 h after onset of sepsis,incidence of WBC<5×10^(9)/L and PLT<100×10^(9)/L were higher,counts of leucocytes,neutrophils and platelets were lower,and CRP was higher in the death group(P<0.05),Within 7 d after onset of sepsis,incidence of WBC<5×10^(9)/L and PLT<100×10^(9)/L were higher,WBC and PLT were lower in the death group(P<0.05).The time to positivity of blood culture in the death group was significantly shorter than that in the cured/improved group(P<0.05).Conclusion Neonates who die of early-onset sepsis is born with lower gestational age and lower birth weight,short-term prognosis was associated with WBC,PLT reduce,and shorter time to positivity of blood culture.