血清CRP、降钙素原、血小板计数在新生儿败血症早期诊断的临床价值

摘要

目的：探讨血清C反应蛋白（ CRP）、降钙素原（ PCT）、血小板计数（ PLT）对诊断新生儿败血症的应用价值，为临床快速准确诊断提供依据。方法选用临床诊断的新生儿败血症患儿60例为研究组，另选同期无并发症的新生儿肺炎60例为对照组。用免疫比浊法测CRP、电化学发光法测PCT、全自动血细胞分析仪测PLT，比较两组的CRP、PCT、PLT水平，同时以CRP＞8mg／L、PCT＞2.0ng／mL、PLT＜100×109／L作为阳性阈值，观察各指标独立及联合诊断新生儿败血症的灵敏度、特异度、阳性预测值、阴性预测值及约登指数。结果新生儿败血症组的CRP、PCT水平明显高于对照组，差异有统计学意义（P＜0.05），PLT水平明显低于对照组，差异有统计学意义（P＜0.05）。PCT的灵敏度、特异度、阳性预测值、阴性预测值及约登指数均优于CRP、PLT，而三个指标联合诊断的灵敏度优于各指标独立诊断。结论 CRP、PCT、PLT对新生儿败血症有很好的临床诊断价值，联合检测能够提高对新生儿败血症的早期诊断水平。%Objective To discuss the diagnostic value of serum CRP,procalcitonin(PCT),and platelet(PLT) count in neonatal sepsis ,and provide a basis for fast and accurate diagnosis .Methods Choose 60 children with neonatal sepsis as re-search group ,and another 60 children of the corresponding period who have got neonatal pneumonia ( without complications ) are chosen as control group.Measure CRP with immunoturbidimetry(ITM),PCT with electrochemiluminescence(ECL),and PLT with automatic blood cell analyzer .Compare the level of CRP ,PCT,PLT between the two groups ,and set CRP>8mg/L, PCT >2.0ng/mL,PLT <100 ×109/L as a positive threshold.Observe the sensitivity,specificity,positive predictive value ( PPV) ,negative predictive value ( NPV) and Youden index of the indexes in diagnosing neonatal sepsis .Results The level of CRP,PCT in the research group are obviously higher than the control group ,differences are statistically significant (P<0.05),the level of PLT is obviously lower than the control group ,differences are statistically significant(P<0.05).The sen-sitivity,specificity,positive predictive value(PPV),negative predictive value(NPV) and Youden index of PCT are better than CRP and PLT,and the joint diagnostic sensitivity of 3 indexes is better than independent diagnosis of each index .Conclusion CRP,PCT,PLT have a good diagnostic value for neonatal sepsis ,and the joint detection can improve the level of early diagno-sis of neonatal sepsis .