血清CRP、PCT及病原菌联合检测对新生儿肺炎患儿的临床价值

Clinical value of combined detection of serum CRP,PCT and pathogenic bacteria in children with neonatal pneumonia

目的探讨血清CRP、PCT及病原菌联合检测对新生儿肺炎患儿的临床价值。方法选择2023年11月-2024年1月本院收治的84例新生儿为研究对象,按其是否确诊为新生儿肺炎分为实验组(新生儿肺炎)和对照组(健康新生儿)两组,实验组54例,对照组30例。通过电化学发光法检测C反应蛋白及降钙素原浓度。病原菌检测通过采取患儿的痰液,进行痰培养后细菌分离,并通过细菌检测仪进行分析。结果实验组54例新生儿肺炎中27例(50%)检测出存在细菌感染,其中革兰阴性菌有17例,革兰阳性菌有10例。革兰阴性菌中大肠埃希菌感染有10例(37.03%),流感嗜血杆菌有4例(14.81%),其他革兰阴性菌感染有3例(11.11%);革兰阳性菌中肺炎链球菌感染有7例(25.93%),金黄色葡萄球菌感染有3例(11.11%)。实验组血清C反应蛋白和降钙素原均明显高于对照组,差异有统计学意义(P<0.05);实验组治疗后血清C反应蛋白明显低于治疗前,差异有统计学意义(P<0.05);实验组治疗后降钙素原明显低于治疗前,差异有统计学意义(P<0.05);实验组血清C反应蛋白、降钙素原及病原菌联合检测诊断阳性率为92.59%,明显高于C反应蛋白(87.04%)、降钙素原(62.96%)及病原菌检测(50%)诊断效能,差异有统计学意义(P<0.05)。结论病原菌检测可以找到患儿的致病菌,但诊断效能较晚;C反应蛋白及降钙素原能够早期诊断新生儿肺炎,可与病原菌检测相辅相成,但其易受治疗的影响。新生儿肺炎血清C反应蛋白、降钙素原及病原菌联合检测可早期提高患儿的诊断效能,有助于值得临床推广应用。

Objective To investigate the clinical value of the combined detection of serum C-reactive protein(CRP),procalcitonin(PCT),and pathogenic bacteria in neonates with pneumonia.Methods Eighty-four neonates admitted from November 2023 to January 2024 were selected and divided into an experimental group with neonatal pneumonia(n=54)and a control group of healthy neonates(n=30).The concentrations of CRP and PCT were measured using the electrochemiluminescence method.Pathogen detection was performed by collecting sputum for culture and bacterial isolation,followed by analysis with a bacterial detector.Results In the experimental group,27 out of 54 cases(50%)tested positive for bacterial infections,including 17 gram-negative and 10 gram-positive bacteria.Among the gram-negative bacteria,Escherichia coli was identified in 10 cases(37.03%),Haemophilus influenzae in 4 cases(14.81%),and other gram-negative bacteria in 3 cases(11.11%).Among the gram-positive bacteria,there were 7 cases(25.93%)of streptococcal infection and 3 cases(11.11%)of Staphylococcus aureus infection.Serum C-reactive protein and procalcitonin in the experimental group were significantly higher than those in the control group,with statistical significance(P<0.05).Serum C-reactive protein after treatment of neonatal pneumonia was significantly lower than that before treatment,and the difference was statistically significant(P<0.05).The procalcitonin after treatment of neonatal pneumonia was significantly lower than that before treatment,the difference was statistically significant(P<0.05).The positive rate of combined detection of serum C-reactive protein,procalcitonin and pathogenic bacteria in neonatal pneumonia was 92.59%,which was significantly higher than that of C-reactive protein(87.04%),procalcitonin(62.96%)and pathogenic bacteria(50%),and the difference was statistically significant(P<0.05).Conclusions Pathogen detection can find pathogenic bacteria in children,but the diagnostic efficiency is relatively late.C-reactive protein and procalcitonin can diagnose neonatal pneumonia early,which can be complementary to pathogen detection,but they are easily affected by treatment.The combined detection of serum C-reactive protein,calcitonin,and pathogenic bacteria can improve the diagnostic efficacy of children in an early stage,which is worthy of clinical application.