降钙素原、C反应蛋白和白细胞计数在新生儿感染性疾病诊断中的应用

目的 研究降钙素原、C反应蛋白、白细胞计数在新生儿感染性疾病中的诊断. 方法 选择郴州市妇幼保健院2010年12月-2011年12月间收治的90例经病原学检测,临床诊断确诊为感染性疾病的患儿作为研究对象,另外选取40例健康新生儿作为对照,所有患儿确诊后采集清晨空腹静脉血,降钙素原检测采用双抗体夹心免疫检测,C反应蛋白采用免疫比浊法定量检测.降钙素原≥0.5 μg/L为阳性,C反应蛋白≥8 mg/L为阳性,白细胞计数≥20×109/L为阳性. 结果 新生儿感染组中PCT水平为(9.31±5.24)μg/L,CRP平均水平为(33.20±20.44)mg/L,白细胞计数(18.3±6.4)×109/L.与对照组相比差异有统计学意义,对照组PCT水平低于新生儿感染组,CRP水平低于新生儿感染组,白细胞计数低于新生儿感染组.且使用PCT、CRP联合诊断新生儿感染疾病的灵敏度为88.5％,特异度为79.2％,ROC工作特征曲线下面积为83.1％;为所有检测方法组合中特异度、灵敏度最高的诊断方法. 结论 本研究证明使用血清降钙素原、C反应蛋白、白细胞计数可以作为诊断新生儿感染性疾病的有效临床指标,对于临床诊断具有重要意义.

Application of Procalcitonin,C-reactive Protein and White Blood Cell Count in the Diagnosis of Neonatal Infectious Diseases

Objective To study the application of procalcitonin（PCT）,C-reactive protein（CRP）and white blood cell count（WBC） in the diagnosis of neonatal infectious diseases. Methods Totally,90 neonates with confirmed infectious diseases diagnosed by pathogenic detection and clinical manifestations hospitalized in Chenzhou Maternal and Child Health Hospital during December,2010 and December,2011 were selected as the research objects,with 40 healthy newborns as controls.Fasting venous blood was collected.PCT was detected by double antibody sandwich immunoassay,and CRP was quantitatively measured with immune turbidimetry.PCT ≥0.5 μg/L,CRP≥8 mg/L and WBC ≥20×109/L were set as positive. Results For the neonatal infection group,the average levels of PCT,CRP and WBC were 9.31 ±5.24 μg/L,33.20±20.44 mg/L and 18.3±6.4×109/L respectively,all significantly higher than the control group.When the neonatal infections were jointly diagnosed by PCT and CRP,the sensitivity and specificity were 88.5% and 79.2%,respectively.And the area under the ROC curve was 83.1%.The combination had the highest sensitivity and specificity among all detection methods. Conclusions Serum procalcitonin,C-reactive protein and white blood cell count can be used as the effective clinical indices in diagnosing neonatal infectious diseases.