C反应蛋白和中性粒细胞百分率在新生儿感染中的临床意义

目的 探讨新生儿急性细菌感染过程中血C反应蛋白(CRP)、外周血白细胞计数(WBC)、中性粒细胞百分率(GR%)的变化及临床意义.方法 48例新生儿感染住院患儿分2组:细菌感染组23例,病毒感染组25例.所有病例入院时检测CRP、WBC、GR%,并细菌培养.细菌感染组入院后即给予抗生素治疗,并24h、48h、72h复查CRP、WBC、GR%,观察三者的动态变化.结果 入院时新生儿细菌感染组CRP、GR%均较病毒感染组显著升高(P＜0.01),而WBC无显著意义(P＞0.05).细菌感染组GR%在入院后48h即开始明显下降(P＜0.01),而CRP则在入院后72h水平才显著降低.CRP、GR%对鉴别细菌或病毒感染均有诊断意义(P＜0.05),而WBC无诊断意义.血清CRP与GR%呈正相关,r为0.65,P＜0.01,WBC与CRP、GR%无显著相关性,r分别为0.35,0.31,P均＞0.05.CRP、GR%灵敏度、阳性预测值、阴性预测值及准确性相似,均高于WBC.结论 新生儿感染中CRP、GR%是一很好的鉴别细菌与病毒感染的诊断指标,其在细菌感染时升高,而WBC对区别细菌或病毒感染无显著意义.

Clinical Significance of C-reactive Protein and Percentage of Neutrophil in Newborns with Acute Bacterial Infection

objective To investigate the changes in serum C-reactive protein(CRP), peripheral white blood cells count(WBC) and the percentage of neutrophillic granulocyte(GR%) during the course of an acute bacterial infection and their clinical significance in the newborns.Methods Of 48 newborns with infection,23 suffered from bacterial infection and 25 viral infection.The venous blood was taken.The determination of CRP,WBC,GR% and bacterial culture, were performed before the treatment and 24,48 and 72 hours after the anti-infective treatment in all the newborns .The dynamic changes in CRP,WBC and GR% were observed .Results Both CRP and GR% were significantly higher in the bacterial infection group than those in the viral infection group(P<0.01) and However,there was insignificantly difference in WBC between both the groups(P>0.05).The levels of GR% 48hours after the treatment and CRP levels 72 hours after the treatment were significantly lower than those before the treatment in the bacterial infection group(P<0.01).The serum level of CRP was significountly positive correlated with that of GR%(r=0.65,P<0.01).WBC was insignificantly correlated with CRP or GR%( r=0.35,0.31 respectively,P>0.05 ).The sensitivity,positive predictive and negative predictive values,and accuracy of CRP were similar to those of GR% and higher than those of WBC.Conclusions CRP and GR% are helpful to differentiating bacterial infection from viral infection in the newborns,but WBC not.