發(fā)布時(shí)間：2018-02-28 00:24

  本文關(guān)鍵詞： 新生兒 敗血癥 降鈣素原 超敏C反應(yīng)蛋白　出處：《昆明醫(yī)科大學(xué)》2012年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：新生兒敗血癥是嚴(yán)重的細(xì)菌感染性疾病,也是臨床上較常見(jiàn)的新生兒極危重癥之一,是造成新生兒殘疾和死亡的主要原因。目前對(duì)新生兒敗血癥的診斷仍缺乏快速而準(zhǔn)確的檢測(cè)手段。我們對(duì)入住我院新生兒病房的新生兒進(jìn)行回顧性分析,以評(píng)估PCT(Procalcitonin, PCT)、hs-CRP(high sensitivity C-reactive protein, hs-CRP)等指標(biāo)在新生兒敗血癥中的價(jià)值,指導(dǎo)敗血癥的臨床診斷和及時(shí)正確治療,降低新生兒死亡率。 目的：探討及評(píng)價(jià)PCT和hs-CRP對(duì)新生兒敗血癥早期診斷的價(jià)值,并與已知的細(xì)菌感染標(biāo)志物進(jìn)行比較。 方法：收集2010年9月至2011年11月我院新生兒室收治的新生兒(日齡3-28天)共183例為研究對(duì)象,按最后出院診斷分為敗血癥組、敗血癥合并并發(fā)癥組、局部感染組及非感染組,分別收集臨床資料及實(shí)驗(yàn)室指標(biāo),包括血常規(guī)、肌酸激酶混合型同工酶(CK-MB)、hs-CRP、PCT等,對(duì)資料進(jìn)行相關(guān)統(tǒng)計(jì)學(xué)分析,并分別計(jì)算各指標(biāo)的靈敏度、特異度、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值及約登指數(shù)等。 結(jié)果：1、PCT與hs-CRP均具有較高的診斷準(zhǔn)確性,但PCT有更高的靈敏度、特異度、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值及約登指數(shù),在診斷的準(zhǔn)確性及真實(shí)性上,PCT要較hs-CRP更好； 2、在新生兒敗血癥的診斷上,PCT與hs-CRP均明顯優(yōu)于白細(xì)胞計(jì)數(shù)及中性粒細(xì)胞百分比、血小板的診斷價(jià)值(P0.05)； 3、PCT與hs-CRP均與敗血癥的嚴(yán)重程度呈正相關(guān),但PCT與敗血癥嚴(yán)重程度的相關(guān)性強(qiáng)于hs-CRP; 結(jié)論：PCT在新生兒敗血癥的診斷方面,在靈敏度、特異度、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值上更優(yōu)于hs-CRP,可以作為診斷敗血癥的參考指標(biāo)；同時(shí)可準(zhǔn)確反映敗血癥的嚴(yán)重程度、是否發(fā)生嚴(yán)重并發(fā)癥等,可用于指導(dǎo)抗生素的使用。
[Abstract]:Neonatal septicemia is a serious bacterial infectious disease, and it is also one of the most common severe neonatal diseases. Is the main cause of neonatal disability and death. At present, the diagnosis of neonatal sepsis is still lack of rapid and accurate means of detection. To evaluate the value of high sensitivity C-reactive protein (hs-CRP) in neonatal septicemia, to guide the clinical diagnosis and correct treatment of septicemia, and to reduce the neonatal mortality. Objective: to evaluate the value of PCT and hs-CRP in the early diagnosis of neonatal sepsis and compare them with the known bacterial infection markers. Methods: a total of 183 newborns (3-28 days old) admitted to our hospital from September 2010 to November 2011 were divided into septicemia group, septicemia complicated with complication group, local infection group and non-infected group according to the final diagnosis. The clinical data and laboratory indexes were collected, including blood routine examination, creatine kinase mixed isozyme CK-MBN hs-CRP PCT and so on. The data were analyzed statistically, and the sensitivity, specificity, positive predictive value of each index were calculated, respectively. Negative predictive value and Jordan index. Results both PCT and hs-CRP had higher diagnostic accuracy, but PCT had higher sensitivity, specificity, positive predictive value, negative predictive value and Jordan index. The accuracy and authenticity of PCT were better than that of hs-CRP. 2. In the diagnosis of neonatal septicemia, both PCT and hs-CRP were better than white blood cell count and percentage of neutrophil. 3PCT and hs-CRP were positively correlated with the severity of sepsis, but the correlation between PCT and the severity of septicemia was stronger than that of hs-CRP. Conclusion the sensitivity, specificity, positive predictive value and negative predictive value of the weight PCT in the diagnosis of neonatal septicemia are better than those of hs-CRP.It can be used as a reference index for the diagnosis of septicemia, and can accurately reflect the severity of septicemia. Whether or not serious complications occur, can be used to guide the use of antibiotics.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R722.1

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