降钙素原协同C-反应蛋白和白介素-6检测对新生儿细菌感染的诊断价值

摘要

目的 探讨降钙素原(procalcitonin,PCT)在新生儿细菌感染(neonatal bacterial infection,NBI)中的应用价值.方法 对出生4 d后108例疑为细菌感染的新生儿临床资料进行回顾性分析.所有患儿通过细菌学或影像学方法判断是否为细菌性感染,并检测血清中PCT、C-反应蛋白(C-reactive protein,CRP)和白介素-6(IL-6)含量.结果 共检测出38例细菌感染患儿,CRP(>10 mg/L)联合IL-6(>100 ng/L)对诊断NBI的敏感性为91.7%,特异性为79.9%,阳性预测值为70.8%,阴性预测值为93.9%; 结合PCT后,其敏感性为98.5%,特异性为66.7%,阳性预测值为58.5%,阴性预测值为98.8%.结论 PCT能进一步提高CRP和IL-6在诊断NBI的敏感性和阴性预测值,是对现有标记物的有益补充.%Objective To explore the application value of procalciton (PCT) in neonatal bacterial infection (NBI). Methods Clinical data of 108 neonates who were doubtful with bacterial infection after born 4 days were analyzed retrospectively. NBI was proved by bacteriology and imaging methods, and the level of PCT, CRP (C-reactive protein) and IL-6 were detected. Results It is confirmed that 38 children suffered with bacterial infection, the sensitivity, specificity, positive predictive value, negative predictive value of CRP (>10mg/L) combined with IL-6 (> 100 ng/L) in diagnosis of NBI was 91.7%, 79.9%, 70.8%, 93.9% respectively. When CRP and IL-6 combined with PCT detection in diagnosis of NBI, the sensitivity, specificity, positive predictive value, and negative predictive value was 98.5%, 66.7%, 58.5% and 98.8% respectively. Conclusion PCT can enhance the sensitivity and negative predictive value of CRP combined with IL-6 in diagnosis of NBI, and it is beneficial supplement for current markers.