PCT、IL-12及CRP对诊断新生儿细菌感染性疾病的价值

摘要

目的 探讨降钙素原(PCT)、白介素质-12(IL-12)及C-反应蛋白(CRP)对新生儿细菌感染性疾病早期诊断及鉴别诊断的作用.方法 对新生儿细菌感染69例于入院时和入院后48h进行PCT、IL-12、CRP水平测定,按出院诊断分为重症感染组、一般感染组,另取非感染性疾病住院新生儿30例作PCT、IL-12、CRP测定,分析比较PCT、IL-12、CRP对感染性疾病的诊断价值.结果 重症感染组新生儿血清PCT、IL-12及CRP水平均明显高于一般感染组和非感染组新生儿,差异有统计学意义(P<0.01);PCT以0.5 ng/mI为临界值时诊断重症感染的敏感性89.75%,特异性66.67%,与CRP、IL-12相比,诊断感染特别是重症感染的敏感性、特异性较高;经有效抗生素治疗后,细菌感染新生儿入院48h血清PCT水平较入院时下降幅度明显大于血清CRP下降幅度.结论 PCT对新生儿感染性疾病的早期诊断及鉴别诊断、对病情程度判断和治疗效果评价有重要价值,且效果优于CRP和IL-12.%Objective To study procalcitonin (PCX ) , IL-12 and CRP for early and differential diagnosis of neonatal infection. Methods The serum PCX, IL-12 and CRP levels were measured in 73 neonates and repeated 48 h later. 73 neonates were divided into severe infection group, common infection group and non-infection group according to discharge diagnosis. Results Serum concentrations of PCX, TL-12 and CRP levels in neonatal severe infection group were significantly higher than those in common group and non-infection group ( all P<0.01) .Serum concentrations of PCX and CRP in neonates with common infection cares were significantly higher than those non-infection cares (P<0.05 ) .PCX was positive in 89.75% severe infection cases, the specificity rate was 66.67%. The sensitivity and specificity rate of PCT were much higher than that of TL-12 and CRP. The level of the serum PCX decreased rapidly during effective antibiotic therapy. Conclusions The measurement of PCT will be very important to the early and differential diagnosis and judgment of therapeutic efficacy of neonatal infection. It is better than IL-12 and CRP.