乳酸和血清胱抑素C评估早产儿败血症病情及预后的临床价值

目的:评估乳酸和血清胱抑素C(Cys C)在早产儿败血症病情严重程度和预后中的应用价值。方法:分析我院新生儿科住院治疗的82例早产儿败血症患者,入院后检测动脉血乳酸、Cys C、血小板(PLT)、C反应蛋白(CRP)、血常规及新生儿危重病例评分(NCIS),分别比较死亡组和存活组间以及极危重组、危重组和非危重组间血乳酸、Cys C、PLT、CRP、WBC、NCIS评分的差异。采用Pearson检验分析乳酸、Cys C、PLT、CRP与NCIS评分之间的相关性。结果:死亡组动脉血乳酸、Cys C水平较存活组高(P<0.05),死亡组PLT、NCIS较存活组低(P<0.05);死亡组CRP与存活组比较差异无统计学意义(P>0.05)。极危重组、危重组血乳酸高于非危重组,极危重组血乳酸高于危重组(P<0.05),极危重组Cys C高于危重组及非危重组(P<0.05);极危重组、危重组PLT均低于非危重组(P<0.05),极危重组、危重组CRP均高于非危重组(P<0.05),极危重组NCIS低于危重组及非危重组,危重组NCIS低于非危重组(P<0.05);动脉血乳酸、Cys C及CRP均与NCIS呈负相关(r分别为-0.680、-0.607、-0.589, P<0.05),但PLT与NCIS呈正相关(r=0.610,P<0.05)。结论:血乳酸和Cys C对评估早产儿败血症疾病的严重程度及预后有一定的应用价值。

The Clinical Value of Lactate and Serum Cystatin C in the Evaluating of the Severity and Prognosis of Septicemia in Premature Infants

Objective: To explore the value of lactate and serum cystatin C (Cys C) levels in the evaluating of the severity and prognosis of septicemia in premature infants. Methods: The 82 cases of premature infants with septicemia whom hospitalized in our department were analyzed, detected their serum Cys C levels, arterial blood lactate levels, platelet (PLT), C-reactive protein (CRP), blood routine and neonatal critical illness score (NCIS). Arterial blood lactate, Cys C, CRP, PLT, WBC and NCIS in the death group and survival group, the extremely critical group, critical group and non-critical group were compared. The correlation between lactate, Cys C, CRP, PLT and NCIS were analyzed by Pearson correlation analysis. Results: The levels of arterial blood lactate and Cys C were higher in the death group than those in the survival group (P<0.05), but the PLT and NCIS were lower in the death group than those in the survival group (P<0.05). For CRP, there was no difference between the death group and survival group (P>0.05). The levels of arterial blood lactate were higher in the extremely critical group and critical group than that in the non-critical group, and arterial blood lactate was higher in the extremely critical group than that in critical group (P<0.05). The levels of Cys C were higher in the extremely critical group than those inthe critical group and non-critical group (P<0.05). The level of PLT was lower in the extremely critical group and critical group than that in the non-critical group (P<0.05). The levels of CRP were higher in the extremely critical group and critical group than that in the non-critical group (P<0.05). The NCIS was lower in the extremely critical group than those in the critical group and non-critical group, and it was lower in the critical group than that in the non-critical group (P<0.05). Arterial blood lactate, Cys C, CRP had negative correlation with NCIS (r=-0.680, -0.607 and -0.589, P<0.05), but PLT had a positive correlation with NCIS (r=0.610, P<0.05). Conclusion: The levels of serum lactate and Cys C have a certain value in assessing the severity and prognosis of septicemia in preterm infants.