查丽 胡金绘 朱红利

    [摘要] 目的 探討血清胰石蛋白(PSP)对早发型新生儿败血症(EONS)的早期诊断价值。 方法 选择2014年1～6月入住淮安市妇幼保健院具有细菌感染危险因素或有疑似细菌感染征象且于出生后24 h内入院的新生儿90例，根据是否符合EONS的诊断标准分为败血症组(33例)和非败血症组(57例)。选择20例同期出生一般情况好，没有感染中毒症状的新生儿作为对照组。分别在两组新生儿生后第1、3和7天留取外周血标本，测定血清中PSP和白细胞介素-6(IL-6)水平，并对资料进行统计分析。 结果 三组血清PSP水平在生后第1、3和7天比较，差异均有高度统计学意义(均P < 0.01)。其中败血症组新生儿PSP水平在生后第1、3和7天均高于非败血症组，差异均有统计学意义(均P < 0.05)；败血症组新生儿血清PSP水平在生后0～3 d呈上升趋势，生后3～7 d呈下降趋势。生后第1天血清PSP水平诊断EONS的曲线下面积为0.802(95%CI：0.700～0.903，P < 0.01)。生后第3天血清PSP水平诊断EONS的曲线下面积为0.836(95%CI：0.743～0.930，P < 0.01)；联合生后第1天血清PSP水平与生后第1天血清IL-6水平诊断EONS的ROC曲线下面积为0.879(95%CI：0.804～0.953，P < 0.01)。 结论 新生儿血清PSP水平对早期诊断EONS具有一定的临床价值。联合检测出生后1 d血清PSP和IL-6水平能提高EONS的诊断敏感性并降低漏诊率。

    [关键词] 新生儿；早发型败血症；胰石蛋白；白介素-6

    [中图分类号] R722.131 [文献标识码] A [文章编号] 1673-7210(2018)08(c)-0088-04

    [Abstract] Objective To evaluate the value of serum pancreatic stone protein (PSP) for the early diagnosis of early-onset neonatal sepsis (EONS). Methods Ninety neonatal with infectious risk factors or infectious symptoms admitted to the Huai′an Maternity and Child Healthcare Hospital Affiliated to Yangzhou University Medical Academy within 24 h after birth from January to June 2014 were enrolled. They were divided into sepsis group (33 cases) and non-sepsis group (57 cases) depending on whether the diagnostic standard of early-onset neonatal sepsis was met. Twenty neonatal with good general situations admited at the same time without infection poisoning manifestation were treated as the control group. The blood samples were obtained from children on 1 ......