降钙素原和hs-CRP在新生儿败血症诊断中的价值

摘要

目的 探讨血清降钙素原、超敏C-反应蛋白(hs-CRP)在新生儿败血症诊断中的价值.方法 败血症组146例在入院时及恢复期采血,用免疫色谱法和免疫浊法比分别测定降钙素原和hs-CRP,并在入院接受抗生素治疗前作血培养;非感染组113例一次性采血测定降钙素原和hs-CRP,并对两组进行比较分析.结果 败血症组降钙素原水平(15.19±12.87ng/mL)显著高于非感染组(0.36±0.08ng/mL),H=13.338,P<0.01;败血症组hs-CRP水平(23.2±4.7mg/L)显著高于非感染组(3.3±1.2mg/L),H=10.271,P<0.01.恢复期降钙素原、hs-CRP均明显下降,以降钙素原≥0.5ng/mL,hs-CRP≥3mg/L为阳性标准,对诊断新生儿败血症的敏感度分别为94.6%和71.5%,特异度分别为85.2%和63.9%.结论 降钙素原、hs-CRP可作为新生儿败血症的早期检测指标,与hs-CRP相比,降钙素原较其优越性更明显,特别对新生儿重症感染如败血症诊断更有价值.%Objective To explore the value of procalcitonin ( PCT ) and high sensitivity C-reactive protein ( hs-CRP ) in early diagnosis of neonatal septicemia. Methods The level of serum PCT was detected by semi-quantitative solid-phase immune chromatography and the level of serum hs-CRP was determined by immune turbidimetry at admission and recovery stage, and blood was cultured before antibiotic treatment in 146 neonates with septicemia, respectively. The blood samples were collected only once for the determination of PCT and hs-CRP in 113 non infection neonates. Results The levels of serum PCT ( 0. 36 ± 0. 08ng/mL vs 15. 19 ± 12. 87ng/mL, H = 13. 338, P < 0.01 ) and serum hs-CRP (3.3 ±1. 2mg/L vs 23. 2 ± 4. 7mg/L, H = 10. 271, P < 0. 01 ) were significantly higher in neonates with septicemia than those in non infection neonates. However, the levels of PCT and hs-CRP in septic neonates decreased significantly in recovery stage. If PCT≥0. 5ng/mL and hs-CRP≥3mg/L were used as the positive criterion, the sensitivities would be 94. 6% and 71. 5% , and the specificities be 85. 2% and 63. 9% for PCT and hs-CRP, respectively. Conclusion PCT and hs-CRP can be markers for early diagnosis of neonatal septicemia. The superiority of PCT is more apparent compared with hs-CRP, especially for the diagnosis of neonates with severe infections such as sepsis.