不同病原菌新生儿败血症患儿血糖异常、血小板计数、白细胞计数及C反应蛋白的变化研究

［摘要］目的 探讨不同病原菌新生儿败血症患儿血糖异常、血小板计数、白细胞计数、Ｃ反应蛋白的变化。方法 选取新生儿败血症患儿108例，按照血培养病原菌种类，将患儿分成革兰阳性菌组46例、革兰阴性菌组43例及真菌组19例，分析3组患儿的一般资料与临床表现情况，比较3组患儿的血糖异常、血小板计数、白细胞计数、Ｃ反应蛋白的变化。结果 在108例新生儿败血症患儿中，感染革兰阳性菌46例（42.59%），其中以凝固酶阴性葡萄球菌（24.07%）、屎肠球菌（9.26%）为主；感染革兰阴性菌43例（39.81%），其中以大肠埃希菌（21.30%）、肺炎克雷伯杆菌（14.81%）为主；感染真菌19例（17.60%），其中以白色假丝酵母菌（9.26%）为主。 革兰阳性菌组的胎龄和出生体重显著优于革兰阴性菌组和真菌组，3组患儿在胎龄及出生体重差异有统计学意义（P＜0.05）；真菌组的发病日龄显著大于革兰阳性菌组和革兰阴性菌组，且革兰阴性菌组的发病日龄显著大于革兰阳性菌组（P＜0.05）。革兰阴性菌组、真菌组的血糖异常比例（34.88%、31.58%）显著高于革兰阳性菌组（13.04%）（P＜0.05）；真菌组的白细胞计数异常、C反应蛋白水平升高的比例显著低于革兰阳性菌组和革兰阴性菌组，且革兰阴性菌组的C反应蛋白水平升高的比例显著高于革兰阳性菌组（P＜0.05）；革兰阴性菌组、真菌组的血小板计数降低的比例显著高于革兰阳性菌组（P＜0.05）。结论 当新生儿败血症患儿白细胞计数明显异常和C反应蛋白水平明显上升时，细菌感染的概率较大；当血小板计数明显下降时，感染革兰阴性菌和真菌概率较大。且革兰阴性菌组、真菌组的血糖异常比例显著高于革兰阳性菌组。

Changes of blood glucose,platelet count,white blood cell count and C-reactive protein in children with neonatal sepsis caused by different pathogens

［Abstract］ Objective〖HTSS〗To investigate the changes of abnormal blood glucose, platelet count, white blood cell count and C-reactive protein in children with neonatal sepsis with different pathogenic bacteria. 〖WTHZ〗Methods〖HTSS〗A total of 108 children with neonatal sepsis were selected. According to the type of blood culture pathogens, the children were divided into 46 Gram-positive bacteria groups, 43 Gram-negative bacteria groups and 19 fungal groups. The general data of the three groups were analyzed. The clinical manifestations were compared with changes in blood glucose abnormalities, platelet counts white blood cell counts and C-reactive protein in the three groups. 〖WTHZ〗Results〖HTSS〗Among 108 cases of neonatal sepsis, 46 Gram-positive bacteria(42.59%) were infected, of which coagulase-negative staphylococci(24.07%) and Enterococcus faecium(9.26%) were the main infections; 43 were Gram-negative bacteria. Cases(39.81%), of which E. coli(21.30%) and Klebsiella pneumoniae(14.81%) were predominant; 19 cases(17.60%) were infected with fungi, of which Candida albicans(9.26%) was the Lord. The gestational age and birth weight of the Gram-positive bacteria group were much better than those of the Gram-negative bacteria group and the fungal group, and the differences in gestational age and birth weight among the three groups of children were statistically significant(P＜0.05). The age was significantly larger than that of the Gram-positive bacteria group and the Gram-negative bacteria group, and the age of onset of the Gram-negative bacteria group was significantly larger than that of the Gram-positive bacteria group(P＜0.05). The proportion of abnormal blood glucose in the Gram-negative bacteria group and the fungal group(34.88%, 31.58%) was significantly higher than that in the Gram-positive bacteria group(13.04%)(P＜0.05); The fungal group had abnormal white blood cell counts and elevated C-reactive protein levels. The proportion of Gram-negative bacteria was significantly lower than that of the Gram-positive bacteria group and the Gram-negative bacteria group, and the proportion of C-reactive protein levels in the Gram-negative bacteria group was significantly higher than that of the Gram-positive bacteria group(P＜0.05). The percentage of platelet count reduction in the group and fungal group was significantly higher than that in the Gram-positive group(P＜0.05). 〖WTHZ〗Conclusion〖HTSS〗When the abnormal white blood cell counts and C-reactive protein levels in children with neonatal sepsis are significantly higher, the probability of bacterial infection is greater; When the platelet count is significantly lowered, it is more likely to be infected with Gram-negative bacteria and fungi. And the proportion of abnormal blood glucose in Gram-negative bacteria group and fungal group was significantly higher than that in Gram-positive bacteria group.