血清降钙素原(PCT)在新生儿感染中的临床应用价值

目的:探讨血清降钙素原(PCT)、C反应蛋白(CRP)、淀粉样蛋白(SAA)、外周血白细胞计数(WBC)及中性粒细胞比例(N)在新生儿感染中的临床应用价值。方法:随机选取2015年10月~2017年6月在我院治疗并确诊感染的出生三日内的新生儿106人,以及未感染新生儿57人,将其分为未感染组、一般感染组及败血症组,比较其血清PCT、CRP、SAA、WBC及中性粒细胞比例。结果:败血症组的N、PCT均高于未感染组(P0.05),而败血症组的WBC高于或者低于未感染组(P0.05);一般感染组的N、PCT均高于未感染组(P0.05);败血症组PCT高于感染组(P0.05)。WBC、N、PCT用于鉴别诊断一般感染和败血症的ROC曲线的曲线下面积依次为0.551、0.580、0.815,当PCT的值设为6.785 ng/mL时,其鉴别诊断一般感染和败血症的灵敏度50.0%,特异度为97.7%。结论:PCT对于诊断败血症有较高的诊断价值,能有效鉴别一般感染和败血症,中性粒细胞比例和白细胞在诊断细菌感染方面是PCT的补充,三者联合诊断可以提高新生儿细菌感染的诊断准确性。

Clinical Application Value of Serum Procalcitonin (PCT) for Neonatal Infection

ABSTRACT Objective: To investigate the clinical application value of serum procalcitonin (PCT), C-reactive protein (CRP), serum amyloid-A (SAA), peripheral blood leukocyte count (WBC) and neutrophil ratio (N) in neonatal bacterial infection. Methods: Randomly selected 106 newborns from October 2015 to June 2017 in our hospital treatment and diagnosis of infection within three days of the birth, and 57 uninfected newborns. A total of 163 infants are divided into uninfection group, general infection group and sepsis group, which were hospitalized in our hospital. The PCT, CRP, SAA, WBC and neutrophil proportion (N) of these three group are compared. Results: There are significant differences in WBC, N and PCT among the three groups (P<0.05), while CRP and SAA are not statistically signifi- cant (P>0.05). The N and PCT of the sepsis group is higher than that of the uninfection group, and the difference is statistically significant (P<0.05). The WBC of the sepsis group is higher or lower than that of the uninfection group, and the difference is statistically significant (P<0.05). The N and PCT of the general infection group is higher than that of the uninfection group, and the difference is statistically sig- nificant (P<0.05). The PCT of the sepsis group is higher than that of the general infection group, and the difference is statistically signifi- cant (P<0.05). The area of ROC curve of the WBC, N and PCT, which for the differential diagnosis of general infection and sepsis is 0.551, 0.580 and 0.815. When the cutoff of PCT is 6.785 ng/mL, the sensitivity of the differential diagnosis of general infection and sepsis is 50.0 %, while the specificity is 97.7%. Conclusion: PCT has a higher diagnostic value for the diagnosis of sepsis, which can effectively identify the general infection and sepsis, the proportion of neutrophils and white blood cells is the supplement of PCT in the diagnosis of bacterial infection, three combined diagnosis can improve the accuracy of diagnosis of neonatal bacterial infection.