前降钙素检测在新生儿败血症诊疗中的应用价值

目的探讨血清前降钙素（PCT）检测在新生儿败血症诊疗中的应用价值。方法75例新生儿败血症患儿为观察组，74例无感染征象的新生儿为对照组，入院时进行PCT、C-反应蛋白（CRP）、血常规和血培养检查，其中观察组在治疗1周后复查PTC和CRP。并对结果进行分析。结果观察组入院时血CRP、PTC水平分别为（23．26±5．68）mg／L、（7．614-4．53）ng/L，明显高于对照组的（6．42±4．54）mg／L、（0．45±0．16）ng／L（t=19．97、14．08，均P〈0．01）；治疗1周后，观察组CRP、PTC水平分别为（4．09±1．09）mg／L、（1．95±0．25）ng／L，治疗前后差异均有统计学意义（t=28．71、12．92，均P〈0．01）。观察组入院时PTC阳性率82．7％、CRP阳性率48．0％、血培养阳性率28．0％，PTC与CRP阳性率差异有统计学意义（x2=5．64，P〈0．05），PTC与血培养阳性率差异有统计学意义（x2=10．40，P〈0．01）。PTC检测以2．5μg／L为临界点，对败血症的诊断敏感度是82．7％，特异度是80．3％。CRP检测以8mg／L为临界点，对败衄症诊断的敏感度是48．7％，特异度是78．4％。结论PTC可作为新生儿败血症早期诊断有价值的指标。

The clinical value of serum procalcitionin in the diagnosis of neonates septicemia

Objective To assess the application value of serum procalcitonin （PCT） for the differentiation between the neonates with or without septicemia. Methods PCT, C-reactive protein （CRP） , blood and blood culture tests were clone in 75 cases of neonatal septicemia as the therapy group, and 74 neonates without the signs of infection as the control group after the admission of our hospital. One week later,the therapy group also reexamined the PTC and CRP tests. Furthermore,the results were analyzed. Results The levels of CRP （23.26±5.68 ） mg/L and PCT （7.61 ±d. 53 ） ng/L in therapy group were dramatically reduced compared with （4.09±1.09 ） rag/L, （1. 95±0.25 ） ng/L in therapy group, and （6.42±4.54） mg/L, （0.45 ±0.16） ng/L in the control group before therapy, the t values are 28.71,12.97 and 19.97,14.08 respectively,and p value are both less than 0.01. The positive rates of PTC, CRP and blood culture were 82.7% ,48.0% 28.0% before the admition to hospital. The differences of PTC and CRP, PTC and blood culture had statistical significances （ X2=5.64, P 〈 0.05 ; X^2 = 10.40, P 〈 0.01 ）. If 2.5 μg/L of PCT and 8mg/L of CRP would be regarded as cutoff point in our study, the sensitivity and specificity of PCT or CRP for diagnosis of neonatal septicemia was 82.7% and 80.3% ,48.7% and 78.4%. Conclusion Our data suggested that the serum PTC is a valuable marker for the early diagnosis of neonatal septicemia.