降钙素原、中性粒细胞CD64、IL-6和CRP检测在新生儿感染性疾病中的诊疗价值

为探讨降钙素原(procalcitonin,PCT)、中性粒细胞CD64、IL-6和CRP早期诊断新生儿感染性疾病及判断预后的价值,选择感染患儿,根据临床表现及血常规、细菌学培养等检查结果确定为细菌组60例、病毒组50例,分别在入院治疗前及治疗3 d后采集空腹血进行PCT、中性粒细胞CD64、IL-6及CRP水平测定,对照组(60例,同期住院的非感染患儿)检测其PCT、中性粒细胞CD64、IL-6及CRP水平,进行统计学分析。采用双抗体夹心免疫层析法测定血清PCT和IL-6水平;采用FCM测定中性粒细胞CD64百分比;采用Aristo特定蛋白分析仪测定CRP水平。结果显示,治疗前细菌组PCT、中性粒细胞CD64、IL-6和CRP水平均明显高于病毒组和对照组(P < 0.05);病毒组与对照组比较,PCT、中性粒细胞CD64、IL-6和CRP水平差异无统计学意义(P > 0.05)。PCT、中性粒细胞CD64、IL-6和CRP诊断新生儿细菌感染性疾病的截断值分别为:0.56 ng/mL、7.01%、8.79 pg/mL、14.5 mg/L。治疗后有效组PCT、中性粒细胞CD64、IL-6和CRP水平与治疗前比较均明显下降(P < 0.05),治疗后无效组PCT、中性粒细胞CD64和IL-6水平与治疗前比较均无明显变化(P > 0.05)。提示PCT作为早期检测感染性疾病的标志物,对新生儿细菌感染更为敏感,而PCT 、中性粒细胞CD64、IL-6和CRP可作为新生儿感染性疾病早期诊断、疗效判断的重要指标。

Clinical value of procalcitonin,neutrophil CD64,IL-6 and CRP for neonatal infection diseases

We aimed to explore the value of procalcitonin (PCT), neutrophil CD64,IL-6 and CRP for the early diagnosis and prognosis of neonatal infection diseases. Sixty patients with bacterial infection and 50 patients with viral infection were selected based on the clinical manifestation, blood routine and bacterial culture. Sixty neonate patients with non-infection diseases were severed as control. Serum levels of PCT, neutrophil CD64, IL-6 and CRP were detected before treatment and three days after treatment respectively for all cases. The levels of PCT and IL-6 in serum were determined by double antibody sandwich immunochromatography. The percentage of neutrophil CD64 was determined by FCM. The level of CRP was determined by Aristo specific protein analyzer. The results showed that before the treatment, the levels of PCT, neutrophil CD64, IL-6 and CRP in the bacterial infection group were significantly higher than those in the viral infection group as well as the control group(P < 0.05), but there were no difference between the viral infection group and the control group (P > 0.05). The cut-off values of PCT, neutrophil CD64, IL-6 and CRP in diagnosing neonatal bacterial infection diseases were 0.56 ng/mL, 7.01%, 8.79 pg/mL and 14.5 mg/L respectively. In the effective group, the levels of PCT, neutrophil CD64, IL-6 and CRP decreased significantly after treatment (P < 0.05), whereas in the ineffective group, there were no differences (P > 0.05). These findings suggest that PCT is the most sensitive index for early diagnosis of neonatal infection diseases. The detections of PCT, neutrophil CD64, IL-6 and CRP could be useful for early diagnosis and treatment efficacy of neonatal infection diseases.