新生儿严重细菌感染血浆降钙素原与CRP和IL-6临床价值对比研究

目的：比较新生儿败血症及败血症休克血降钙素原（PCT）与C反应蛋白（CRP）和白介素-6（IL-6）的变化，探讨血中前降钙素原作为新生儿严重细菌感染诊断指标的敏感性、可靠性及对预后评估的作用。方法：采用半定量固相免疫测定法测定108例新生儿败血症（40例合并败血症休克）的血浆PCT水平，并比较同期CRP和IL-6水平。结果：新生儿败血症患儿血浆PCT阳性检出率明显高于正常对照组；其中败血症休克组尤为明显；败血症休克患儿发生率及死亡率随PCT值升高而升高；PCT与血清CRP、IL-6水平呈正相关；PCT的敏感性（87．5％）、特异性（82．4％）、阳性预测值（74．5％）和准确性（84．3％）最高。结论：新生儿败血症及败血症休克时PCT升高较早，且随病情的加重持续升高。PCr对新生儿败血症及败血症休克诊断指标的敏感性、可靠性及对预后评估优于CRP和IL-6。

The clinical value of comparative study between procalcitonin, C-reactive protein and IL-6 in neonatal sepsis

Objective:To identify the sensitivity,reliability in diagnosis and prediction the outcome for neonatal sepsis and septic shock.Methods:Plasma PCT levels of 108 neonates with sepsis(40 with septic shock) were measured by semi-quantitative solid phase immunoassay.At the same time,the plasma CRP and IL-6 levels were observed.Results:The positive rate of PCT was significantly higher in patients with neonatal sepsis and septic shock compared with control group and plasma PCT levels of septic shock group was the highest.The prevalence and fatality rate of septic shock were associated to the plasma levels of PCT,the higher was the PCT,the much higher was the prevalence and fatality rate of septic shock.The plasma PCT levels were significantly correlated with the plasma levels of CRP and IL-6.The sensitivity(87.5%),specificity(82.4%),positive predictive values(74.5%),accuracy(84.3%) of PCT all higher than that of CRP and IL-6.Conclusion:Increased plasma PCT levels in the early stage of neonatal sepsis and septic shock were associated with the severity of illness.PCT is superior than CRP and IL-6 as a marker of severe bacterial infection.