Hs-CRP、CD64、sTREM-1水平联合检测在新生儿败血症诊断中的应用

为了探讨Hs-CRP、CD64、s TREM-1水平联合检测在新生儿败血症诊断中的应用价值。2016年3月至2017年9月,选择我院收治的新生儿败血症100例作为观察组,100名健康儿作为对照组。采用流式细胞仪检测受试新生儿CD64的平均荧光强度(MFI),使用ELISA试剂盒测定血清s TREM-1水平,使用散射比浊法测定血清Hs-CRP水平。观察组的Hs-CRP、CD64和s TREM-1水平均显著高于对照组,并且观察组治疗72 h后的Hs-CRP、CD64和s TREM-1水平较治疗前均显著降低。100例确诊的败血症患儿的Hs-CRP、CD64和s TREM-1阳性率分别为78.0%、91.0%和82.0%,健康新生儿的Hs-CRP、CD64和s TREM-1阴性率分别为94.0%、96.0%和95.0%。随着治疗时间的延长,败血症新生儿的Hs-CRP、CD64和s TREM-1水平均逐渐降低,治疗3 d后基本趋近于正常儿童的水平。CD64的阳性预测值和阴性预测值分别为95.8%和91.4%,均高于Hs-CRP(92.9%和81.0%)和s TREM-1(94.3%和84.1%)。3项指标联合检测的败血症阳性率为97.0%,健康新生儿的阴性率为99.0%,均高于单独检测(p<0.05)。3项指标联合检测的阳性预测值和阴性预测值分别为99.0%和97.1%,显著高于3项指标单独检测(p<0.05)。Hs-CRP、CD64和s TREM-1在败血症新生儿中的水平明显升高,并且与病情进展有关。Hs-CRP、CD64和s TREM-1的联合检测在新生儿败血症诊断中的预测价值高于3项指标单独检测,对临床诊断和治疗具有重要参考价值。

Combined Detection of Hs-CRP,CD64 and sTREM-1 Levels Applied on the Diagnosis of Neonatal Septicemia

To investigate the value of combined detection of Hs-CRP,CD64 and s TREM-1 in the diagnosis of neonatal septicemia,from March 2016 to September 2017,100 cases of neonatal septicemia admitted in our hospital were selected as observation group and 100 healthy children as control group.The mean fluorescence intensity(MFI)of CD64 was measured by flow cytometry,serum s TREM-1 levels were measured by ELISA kits,and serum Hs-CRP levels were measured by using a nephelometric method.The levels of Hs-CRP,CD64,and s TREM-1 in the observation group were significantly higher than those in the control group.In addition,the levels of Hs-CRP,CD64,and s TREM-1 after 72 h in the observation group were significantly lower than those before treatment.The positive rates of Hs-CRP,CD64,and s TREM-1 in 100 confirmed neonatal septicemia were 78.0%,91.0%,and 82.0%,respectively.The negative rates of Hs-CRP,CD64 and s TREM-1 in healthy neonates were94%,96%and 95%respectively.With the prolongation of treatment time,the levels of hs-CRP,CD64 and s TREM-1 in neonates with sepsis decreased gradually,and after 3 days of treatment,the levels of hs-CRP,CD64 and s TREM-1 tended to the level of normal children.The positive and negative predictive values of CD64 were95.8%and 91.4%,respectively,and higher than those of Hs-CRP(92.9%and 81.0%)and s TREM-1(94.3%and84.1%).The septicemia positive rate of co-detection of three indicators was 97%,and the negative rate of healthy neonates was 99.0%,which were higher than those of the single test(p<0.05).The positive and negative predictive value of the combined detection of the three indicators were 99.0%and 97.1%,respectively,which was significantly higher than separate detection of three indicators(p<0.05).The levels of Hs-CRP,CD64 and s TREM-1 in neonates with sepsis were significantly increased,which was related to the progress of the disease.The combined detection of Hs-CRP,CD64,and s TREM-1 in the diagnosis of neonatal septicemia has a higher predictive value than separate detection of three indicator,and it has important reference value for clinical diagnosis and treatment.