新生儿感染性疾病中相关炎症标志物联合应用的诊断价值

Diagnostic Value of New Combined Detection in Neonatal InfectiousDiseases

分析新生儿感染病患中非特异性早期炎症指标的诊断效价。选取本院从2019年1月至2019年12月总计167名新生儿病房住院的患儿,根据是否感染分为感染组(n1=71)和非感染组(n2=96)。分析两组患儿入院时或未经治疗时的第1次实验室检查资料,比较两组患儿血清中的降钙素原(PCT)、C反应蛋白(CRP)、血清淀粉样蛋白(SAA)、外周血白细胞计数(WBC)等指标的灵敏度、特异度以及受试者工作特征曲线,分析各指标对于新生儿感染性疾病的诊断效能。试验组与对照组各项指标结果比较,得出PCT、CRP、SAA、WBC单项检测、传统非特异性早期炎症指标联合检测以及“新联合检测”的灵敏度分别为:16.9%、11.3%、14.1%、15.5%、29.6%、36.6%;特异度分别为:97.9%、97.9%、96.9%、85.5%、86.5%、85.4%;ROC曲线下面积分别为:0.574、0.546、0.555、0.52、0.58、0.61。单项非特异性早期炎症标志物诊断效价不高,联合检测意义更大,适当引入更多高诊断效价的非特异性指标进行组合检测可能更有助于新生儿感染性疾病的早期诊治。

To analyze the diagnostic value of non-specific early inflammatory markers in neonatal infectious diseases,this study constructed a retrospective case-control analysis,167 patients in the neonatal ward of the hospital were divided into infection group and non-infection group.There were 71 naonates in the infection group and 96 naonates in non-infectious group.The data of the first laboratory examination on admission or untreated were analyzed in both groups,the sensitivity,the specificity and the ROC curve of procalcitonin(PCT),C-reactive protein(CRP),serum amyloid protein(SAA)and peripheral blood white blood cell count(WBC)were compared between the two groups.The diagnostic efficacy of each index in neonatal infectious diseases was analyzed.The test group and the control group were compared with each index result.The single detection of the above indicators in the two groups is not significant as an early inflammation indicator,but combined detection has certain significance.The sensitivity of PCT,CRP,SAA,traditional combined detection and new combined detection were 16.9%,11.3%,14.1%,15.5%,29.6%and 36.6%respectively.The specificity were 97.9%,97.9%,96.9%,85.5%,86.5%and 85.4%respectively.The area under the ROC curve were 0.574,0.546,0.555,0.52,0.58 and 0.61 respectively.The diagnostic value of single non-specific early inflammatory markers is not strong,and the combined detection is more significant.And it may be helpful for the early diagnosis and treatment of neonatal infectious diseases to properly introduce more non-specific indicators with high diagnostic potency for combined detection.Especially,serum amyloid protein is a new indicator that is efficient and economical,adding it to joint testing may help in the early diagnosis and treatment of neonatal infectious diseases.