PCT、hs—CRP和血小板在新生儿败血症诊断中的价值及与病情的关系(1)
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[摘要] 目的 探讨血清降钙素原(PCT)、超敏C—反应蛋白(hs—CRP)和血小板在新生儿败血症诊断中的价值及与病情的关系。 方法 对我院住院治疗的66例新生儿败血症患者临床资料进行回顾性分析,选择同期60例健康新生儿为对照组。比较两组血清PCT、hs—CRP和血小板的水平,计算三者诊断新生儿败血症的敏感性、特异性。 结果 败血症组患儿PCT及hs—CRP水平显著升高(P < 0.05),血小板水平显著下降(P < 0.05);PCT、hs—CRP和血小板诊断新生儿败血症的敏感性分别为84.8%、69.7%和53.0%,特异性为75.0%、50.0%和22.5%;败血症组患儿恢复期PCT及hs—CRP水平显著降低,血小板水平显著升高,与疾病初期相比差异具有统计学意义(P < 0.05)。 结论 PCT、hs—CRP和血小板对新生儿败血症具有诊断意义,能较好地反应患儿病情变化。
[关键词] 败血症;新生儿;降钙素原;超敏C—反应蛋白;血小板
[中图分类号] R722.1 [文献标识码] B [文章编号] 1673—9701(2012)27—0056—02
Diagnostic value of PCT, hs—CRP and platelet in neonatal septicemia and their relationship with disease condition
HU Xinde1 LIU Baotao2
1.Department of Clinical Laboratory,the Second People's Hospital of Shaoyang City in Hunan Province,Shaoyang 422000,China;2. Department of Neonatology,the Second People's Hospital of Shaoyang City in Hunan Province,Shaoyang 422000,China
[Abstract] Objective To explore the diagnostic value of PCT, hs—CRP and platelet in neonatal septicemia and their relationship with disease condition. Methods A total of 66 cases with neonatal septicemia were retrospectively analyzed. 60 cases of healthy neonates were selected as control group. PCT, hs—CRP and platelet between two groups were compared, and the sensitivities and specificities for neonatal septicemia were studied. Results Compared with control group, PCT and hs—CRP greatly increased and platelet decreased in neonatal septicemia group (P < 0.05); The sensitivities were 84.8%, 69.7% and 53.0% and the specificities were 75.0%, 50.0% and 22.5% for PCT, hs—CRP and platelet. Compared with initial stage, PCT and hs—CRP increased and platelet decreased greatly in recovery stage (P < 0.05). Conclusion PCT, hs—CRP and platelet have significant diagnostic values for neonatal septicemia. They are valuable for evaluating the disease condition.
[Key words] Septicemia; Newborn; Procalcitonin; High sensitive C—reactive protein; Platelet
新生儿败血症指新生儿期细菌侵入血液循环,并在其中繁殖和产生毒素所引起的全身性感染。在发展中国家其病死率可达50%,早期诊断及治疗是降低其病死率的关键[1]。血培养是诊断新生儿败血症的金标准,但耗时长,且新生儿败血症疾病进展快。因此快捷可靠的实验室指标有助于疾病早期诊断,改善患儿预后。本文研究的目的是检测新生儿败血症血清降钙素原(PCT)、超敏C—反应蛋白(hs—CRP)和血小板的水平,探讨其在新生儿败血症诊断中的价值及与病情的关系。
1 资料与方法
1.1 临床资料
选择2010年2月~2012年2月本院诊治的66例新生儿败血症患者为研究对象,所有患儿均行血培养,证实为阳性,符合2003年发布的《新生儿败血症诊断标准修订方案》。66例患儿男42例,女24例,发病日龄1~26 d,平均日龄(12.09±3.76)d。选择同期无感染症状的60例健康新生儿为对照组,其中男36例,女24例,日龄1~25 d,平均日龄(11.98±3.56)d。两组新生儿在年龄、性别等方面差别无统计学意义(P > 0.05),具有可比性。
1.2 检测方法
在应用抗生素前采静脉血进行血培养、PCT、hs—CRP和血小板的检测,采用免疫发光法检测PCT,以PCT≥ 0.5 μg/L为阳性。采用免疫比浊法检测hs—CRP,以hs—CRP≥8 mg/L为阳性。采用全自动血细胞分析仪检测血小板,以血小板<100×109/L做为临界值。
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