降钙素原、C反应蛋白及白细胞计数在新生儿缺氧缺血性脑病中的诊断价值

Diagnostic value of procalcitonin, C-reactive protein and white blood cell count in neonatal hypoxic-ischemic encephalopathy

目的通过分析新生儿缺氧缺血性脑病(hypoxic-ischemic encephalopathy,HIE)患儿外周血中降钙素原(PCT)、C反应蛋白(CRP)和白细胞计数(WBC)水平,探讨三种炎性指标在HIE中的诊断价值。方法选择2017年1月～2018年8月我院儿科收治的HIE患儿66例,依据产妇病史,患儿临床表现、头部CT报告以及Apgar评分等将HIE患儿分为轻、中、重三组。分别用瑞士罗氏公司Cobas E601电化学发光免疫分析仪和日本Sysmex公司XE-2100全自动血液分析仪检测血清中PCT、CRP及全血中WBC水平。分析对照组及各患儿组三种炎性指标水平、治疗前后变化,并通过ROC曲线分析各指标在HIE诊疗中的价值。结果 HIE患儿血清PCT、CRP和全血中WBC水平均较对照组明显升高(P<0.05)。PCT、CRP水平随HIE病情加重而升高(P<0.05)。轻中度HIE患儿组间WBC水平差异无统计学意义(P>0.05),其他各患儿组间WBC水平差异有统计学意义(P<0.05)。结论 PCT、CRP及WBC可作为HIE诊断及病情判断的辅助依据,其中PCT对HIE患儿诊断价值和特异性最高,WBC最低。

Objective To investigate the clinical value of procalcitonin(PCT), C-reactive protein(CRP) and white blood cell count(WBC) in neonatal hypoxic-ischemic encephalopathy(HIE). Methods 66 children with HIE were selected in our hospital from Jan 2017 to Aug 2018. According to history of maternity, clinical manifestation, imaging examination and Apgar score of children, they were divided into three groups: mild group, moderate group and severe group. The levels of PCT, CRP in serum and WBC in whole blood were detected by Cobas E601 Electrochemiluminescence Immunoanalyzer of Roche Company of Switzerland and XE-2100 automatic Blood Analyzer of Sysmex Company of Japan. The levels of three inflammatory indexes in the control group and each HIE group and the changes before and after treatment were analyzed. The value of each index in the diagnosis and treatment of HIE was analyzed by ROC curve. Results The levels of serum PCT, CRP and WBC in HIE patients were significantly higher than those in the control group(P<0.05). The serum PCT and CRP levels increased with the severity of the disease(P<0.05). There was no significant difference in WBC level between mild group and moderate group(P>0.05), but there were significant differences between other groups(P<0.05). Conclusion PCT, CRP and WBC can be used as auxiliary evidence for diagnosis and condition judgement of HIE. The diagnostic value and specificity in children with HIE of PCT is the highest, and WBC is the lowest.