降钙素原、IL-6及CRP诊断新生儿宫内细菌感染的临床价值

目的:探讨降钙素原、IL-6及CRP对新生儿宫内细菌感染诊断的临床价值。方法:采用回顾性分析方法,对121例疑似宫内细菌感染的新生儿的相关临床资料进行比较分析。通过影像学或细菌学方法对患儿进行检查判定感染类型,并检测患儿脐血中的降钙素原、C-反应蛋白(CRP)和白细胞介素-6(IL-6)的水平。结果:在121例患儿中41例确定为细菌感染,IL-6(100ng/L)与CRP(10mg/L)联合对诊断新生儿宫内细菌感染的敏感性为90.1%,特异性为76.9%,阴性预测率为91.7%,阳性预测率为71.9%;与PCT结合后,诊断新生儿宫内细菌感染的敏感性升高至98.3%,特异性为67.8%,阴性预测率为99.2%,阳性预测率为57.0%。结论:脐血PCT可作为新生儿宫内细菌感染诊断的有效指标,可明显提高IL-6与CRP诊断新生儿宫内细菌感染的阴性预测值和敏感性,指导临床治疗。

Effect of Procalcitonin Combined With IL-6 and C-reactive Protein inDiagnosis of Intrauterine Bacterial Infection in Neonates

Objective:To evaluate the clinical value of procalcitonin combined with IL-6 and C-reactive protein in diagnosis ofintrauterine bacterial infection in neonates.Methods:The clinical date of 121 neonates who were suspected cases of intrauterine bacterialinfection were analyzed retrospectively. The level of PCT, IL-6 and CRP were detected and the intrauterine bacterial infection wasproved by imaging and bacteriology.Results:In 121 neoates, 41 children were confirmed as intrauterine bacterial infection. Thesensitivity value of IL-6 (>100ng/L) combined with CRP detection in diagnosis of NBI was 90.1%, the specificity was 76.9%, and thenegative predictive rate was 91.7%, the positive predictive rate was 71.9%. When IL-6 and CRP combined with PCT was used indiagnosis of NBI, the sensitivity value was 98.3%, the specificity was 67.8%, the negative predictive rate was 99.2%, and the positivepredictive rate was 57.0%.Conclusion:PCT can be used as the auxiliary diagnosis of intrauterine bacterial infection, and can enhance thenegative predictive value and sensitivity of IL-6 combined with CRP in diagnosis of NBI.