降钙素原联合C-反应蛋白在诊断和治疗早期新生儿败血症中的应用

目的评价联合检测血清降钙素原(PCT)与C-反应蛋白(CRP)对新生儿败血症诊断和治疗的临床价值。方法选取我院新生儿败血症患儿54例作为观察组,其中包括29例为临床败血症患者,25例为败血症确诊者,并选择30名健康新生儿作为对照组。测定并比较分析两组患者血清PCT与CRP水平及动态监测患者治疗前后血清PCT与CRP水平。结果①观察组血清PCT、CRP水平显著高于对照组,差异有统计学意义(P<0.05);②以PCT>2ng/mL为临界值,诊断新生儿败血症的灵敏度和特异度分别为87.04%和93.33%;以CRP>8mg/L为临界值,CRP的灵敏度和特异度分别为90.7%和63.33%;两者的阳性预测值均较高;③经有效抗菌药物治疗后,观察组的血清PCT转阴、CRP水平与治疗前比较,差异有统计学意义(P<0.05)。结论血清PCT、CRP联合检测对新生儿败血症早期诊断有一定的临床价值。动态监测其变化有助于合理使用抗生素,并协助临床判断疾病的预后。

Application of the combined determination of serum procalcitonin and C-reactive protein in diagnosis of neonatal sepsis

Objective To evaluate clinical value of the combined determination of serum procalcitonin and C-reactive protein in diagnosis of neonatal sepsis.Method A total of 54 hospitalized sepsis of the newborns were selected randomly as observation group,which including 29 cases of clinical sepsisi patients and 25 cases diagnosed as sepsis,and 30 cases of healthy newborns as control group.The two groups of serum PCT and CRP results were determined and analysed respectively.Results ① Serum PCT and CRP level in the observation group were significantly higher than that of control group which had statistically significant(P<0.05);② For the assessment of bacterial infection,setting the PCT critical value of >2 ng/mL,the sensitivity was 87.04% and the specificity was 93.33%.While for the CRP,setting threshold for >8 mg/L,the sensitivity was 90.7% and the specificity was 63.33%.Both of their positive predictive value were of a high leve1.③ There was statistical significance of the level CRP in bacterial infection group between before and after the antibiotic treatment(P<0.05),PCT level turned negative.Conclusions The combined determination of serum PCT and CRP help diagnose and estimate neonatal sepsis.Monitoring dynamically PCT and CRP level will help to evaluate the treatment of neonatal sepsis with timely and appropriate use of antibiotics.