早期诊断新生儿败血症的实验室检测项目评价

目的：探讨血清降钙素原（PCT）、超敏-C反应蛋白（hs-CRP）、白介素-6（IL-6）和白细胞（WBC）计数共四项检测项目在早期诊断新生儿败血症中的方法学评价。方法选取2013.6.1～8.31期间新生儿科败血症患儿84例，正常新生儿140例，采用电化学发光法测定患儿血清的PCT和 IL-6水平，散射比浊法测定 hs-CRP水平，同时用 XE-2100检测患儿全血的白细胞。结果败血症患儿的血清 PCT，hs-CRP 及 IL-6和正常新生儿相比差异有统计学显著性意义（t＝6.37～10.58，P＜0.01），而 WBC在二者之间比较差异无统计学意义（t＝3.15，P＞0.05）。而 PCT，IL-6和 hs-CRP三项联合检测诊断新生儿败血症的灵敏度为98.81％，特异度为90.24％，高于其中任何一单项检测的灵敏度和特异度；同时 PCT在检测新生儿败血症，0.5 ng／ml≤PCT≤2 ng／ml时，以革兰阳性菌感染为主；PCT＞2 ng／ml时以革兰阴性菌感染为主，革兰阳性菌感染和革兰阴性菌感染比较差异有统计学意义（χ2＝4.646.37～35.05，P＜0.05）。结论 PCT，hs-CRP和 IL-6的检测可用于新生儿败血症的早期临床诊断，具有灵敏度高、特异性强等特点，为早期的新生儿败血症的诊断和治疗提供依据。

Evaluation of Laboratory Testing Proj ect for Early Diagnosis of Neonatal Sepsis

Objective To investigate the serum procalcitonin （PCT）,interleukin-6 （IL-6 ）,hypersensitive C-reactive protein （hs-CRP）and white blood cells （WBC）joint detection in the value of early clinical diagnosis of neonatal sepsis.Methods Choose 84 cases with sepsis and 140 cases of mormal newborn in children between 2013.6.1～2013.8.31.Used the electro-chemical luminescence method and scattering turbidimetric method to detect levels of serum PCT,IL-6 and hs-CRP respec-tively,at the same time test whole blood white cells with XE-2100 instrument.Results There were significant difference be-tween serum levels of PCT,hs-CRP and IL-6 of the patients with sepsis and normal newborns （t=6.37～10.58,P〈0.01） and no statistically significant difference for WBC （t=3.15,P〉3.15）.But joint detection of PCT,IL-6 and hs-CRP for neo-natal sepsis,the sensitivity was 98.81%,specificity was 90.24%,higher than any of them a detection sensitivity and special-ity degree.PCT in detection of neonatal sepsis,when 0.5 ng/ml≤PCT≤2 ng/ml,it was priority to with gram-positive bac-terium infection,and when PCT〉2 ng/ml,was priority to with gram-negative bacteria infection,compared G＋ bacteria infec-tion and G- bacteria infection,the difference was statistically significant （χ^2=4.646.37~35.05,P〈0.05）.Conclusion PCT,hs-CRP and IL-6 detection has high sensitivity,strong specificity,they can provide evidence for early diagnosis and treatment of neonatal sepsis.