外周血RDW、PCT联合乳酸检测对新生儿败血症病情的评估价值

Evaluation Value of Peripheral Blood RDW,PCT and Lactic Acid for Severity of Neonatal Septicemia

目的:探讨外周血红细胞分布宽度(RDW)、降钙素原(PCT)联合乳酸检测对新生儿败血症(NS)病情的评估价值。方法:选取2019年5月~2022年12月在本院收治的NS患儿132例为研究对象,根据新生儿危重症评分(NCIS)将NS组患儿分为非危重组(NCIS>90分,94例)和危重组(70≤NCIS≤90分,38例),比较两组外周血RDW、PCT、乳酸水平,采用受试者工作特征曲线(ROC)评价上述指标对危重NS的诊断价值,采用Spearman分析指标与病情严重的相关性。结果:危重组胎龄<37周占比高于非危重组,出生体重低于非危重组(P<0.05)。危重组患儿外周血RDW、PCT及乳酸水平均高于非危重组(P<0.05);ROC结果分析显示,外周血RDW、PCT、乳酸及其联合检测评估危重NS患儿的曲线下面积(AUC)分别为0.844、0.645、0.643、0.874(P均<0.05);Spearman显示,RDW、PCT、乳酸均与NS患儿病情严重程度呈正相关(P均<0.05)。结论:外周血RDW、PCT和乳酸均与NS患儿病情严重程度密切相关,临床可通过联合检测外周血RDW、PCT和乳酸水平来辅助评估NS患儿病情。

Objective:To explore the evaluation value of peripheral blood red blood cell distribution width(RDW),procalcitonin(PCT)and lactic acid for severity of neonatal septicemia(NS).Methods:A total of 132 children with NS admitted to the hospital were enrolled as the research objects between May 2019 and December 2022.According to neonatal critical illness score(NCIS),children were divided into non-critical group(>90 points,94 cases)and critical group(70-90 points,38 cases).The levels of peripheral blood RDW,PCT and lactic acid in the two groups were compared.The diagnostic value of the above three indexes for critical NS was evaluated by receiver operating characteristic(ROC)curves,and their correlation with disease severity was analyzed by Spearman analysis.Results:The proportion of gestational age<37 weeks in critical group was higher than that in non-critical group,while birth weight was lower than that in non-critical group(P<0.05).The levels of peripheral blood RDW,PCT and lactic acid in critical group were higher than those in non-critical group(P<0.05).The results of ROC curves analysis showed that area under the curve(AUC)values of RDW,PCT,lactic acid and combined detection for evaluating critical NS were 0.844,0.645,0.643 and 0.874,respectively(P<0.05).Spearman analysis showed that RDW,PCT and lactic acid were positively correlated with disease severity in NS children(P<0.05).Conclusion:The peripheral blood RDW,PCT and lactic acid are closely related to disease severity in NS children.Clinically,combined detection of the three indexes can be applied to evaluate disease severity in NS children.