探讨血清降钙素原定量测定在新生儿血流感染诊断中的临床价值

To explore the clinical value of serum procalcitonin quantitative determination in the diagnosis of neonatal bloodstream infection

目的为了更好的指导临床对新生儿血流感染的诊断,探讨定量测定血清降钙素原(PCT)的价值和意义。方法通过随机数字表的方法从2017年11月—2018年4月间在我院治疗的新生儿血流感染患者中选取127例作为观察组,采用相同的方法从同时间段来我院行健康体检的新生儿中选取127例作为对照组,所有新生儿均通过电化学发光法和免疫比浊法行PCT和C反应蛋白(CRP)检测,比较检测结果差异。结果研究数据显示,对照组和观察组患儿的PCT水平依次为(0.31±0.13)μg/L和(9.32±5.25)μg/L,而两组患儿CRP水平依次为(3. 88±1. 20) mg/L和(33. 22±20. 45) mg/L,观察组患儿PCT和CRP含量明显增加且组间比较差异具有统计学意义(P<0.05);借助ROC曲线分析发现,PCT和CRP的ROC曲线下的面积分别为0.886和0.687,二者最佳临界值分别为0.51μg/L和8.04 mg/L,和CRP相比,PCT的ROC曲线下面积、阴性预测值、灵敏度均明显增加,组间比较差异具有统计学意义(P<0.05)。结论将血清PCT用于新生儿血流感染诊断中,能够提高临床诊断准确率,可以作为评估病情和判断预后的可靠指标,值得临床应用。

Objective In order to better guide the clinical diagnosis of neonatal bloodstream infection,we discussed the value and significance of quantitative determination of serum procalcitonin( PCT). Methods 1127 cases of patients with neonatal blood flow infection treated in our hospital from January 2017 to April 2018 were selected as observation group by the method of random numbers. The same method was used to select 127 cases of the healthy newborns from the same time period in our hospital as the control group. Photoluminescence assay and immunoturbidimetry assay were used to detect PCT and C reactive protein( CRP),and analyzed the results.Results The study data showed that the PCT levels of the children in the observation group and the control group were( 0.31±0.13) μg/L and( 9.32±5.25) μg/L,while the levels of CRP in the two groups were( 3.88±1.20)mg/L and( 33.22± 20.45) mg/L respectively. The contents of PCT and CRP in the children of the observation group were significantly increased and the difference between the two groups was statistically significant( P < 0.05). The ROC curve analysis showed that the area under the ROC curve of PCT and CRP was 0.885 and 0.688 respectively,and the best critical values of the two levels were 0.51 μg/L and 8.04 mg/L respectively. Compared with CRP,the area,negative predictive value and sensitivity of the calcitonin original ROC curve increased obviously,and the difference between the two groups were statistically significant( P< 0.05). Conclusions The use of PCT in the diagnosis of neonatal blood flow infection could improve the accuracy of clinical diagnosis. It can be used as a reliable index for evaluating the disease and judging the prognosis. It is worthy of clinical application.