血常规、C反应蛋白及降钙素原在新生儿败血症中的诊断价值

摘要

目的 探讨分娩方式及分娩时情况对新生儿败血症的影响,并分析血常规、C反应蛋白(CRP)及降钙素原(PCT)等感染指标在新生儿败血症中的诊断价值.方法 选取40例于西安交通大学第二附属医院新生儿科住院诊断的新生儿作为败血症组,选取同一时期诊断为肺炎的新生儿41例作为肺炎组,入院后采集病史,行体格检查并检测血常规、CRP、PCT、电解质、血乳酸及血糖等感染相关指标.结果 败血症组患儿自然分娩率高于肺炎组,剖宫产率低于肺炎组,差异有统计学意义(x2=4.245,P＜0.05);败血症组患儿白细胞计数(WBC)、中性粒细胞(N)明显低于肺炎组,差异有统计学意义(t值分别为-5.276、-5.765,均P＜0.05),而血红蛋白、血小板计数、CRP及PCT两组间比较,差异无统计学意义,均P＞0.05;两组患儿血气分析中pH值、碳酸氢根离子、血糖、乳酸及生化指标中电解质的水平比较,差异均无统计学意义,均P＞0.05.结论 败血症的发生与分娩方式有一定关系.此外,败血症患儿早期更容易出现白细胞及中性粒细胞计数降低,而CRP的变化不显著,因此白细胞及中性粒细胞计数可以反映早期病情变化.%Objective To explore the effect of delivery mode and production conditions on neonatal sepsis and analyze the diagnostic value of infection indexes including blood routine examination,c-reactive protein (CRP) and procalcitonin (PCT) for neonatal sepsis.Methods Forty cases diagnosed in neonatal department of Second Affiliated Hospital of Xi' an Jiaotong University were selected in sepsis group.At the same period 41 cases diagnosed with pneumonia were selected in pneumonia group.Medical history was collected after admission,physical examination was performed,and infection related indicators of blood routine,CRP,PCT,electrolytes,blood lactate and blood sugar were detected.Results Compared to pneumonia group,the natural birth rate was higher and cesarean section rate was lower in sepsis group with statistical significance (x2 =4.245,P ＜ 0.05).In sepsis group white blood cell count and neutrophil count were significantly lower than those in infection group,and the differences were statistically significant (t value was-5.276 and-5.765,respectively,both P ＜ 0.05).But the differences in hemoglobin,platelet count,CRP and PCT between two groups were not significant (all P ＞ 0.05).There was no statistical significance between two groups in pH value,bicarbonate ions,blood glucose,lactic acid and electrolyte (all P ＞ 0.05).Conclusion The occurrence of sepsis has certain relationship with delivery mode.In addition,children with sepsis at early stage are more likely to have reduced white blood cells and neutrophils count,and the change of CPR is not significant.So white blood cells and neutrophils count can reflect the disease at early stage.