本文選題：早產(chǎn)兒 + 新生兒�。� 參考：《大連醫(yī)科大學》2013年碩士論文

【摘要】：目的： 研究早產(chǎn)新生兒血清降鈣素原（Procalcitonin，PCT)的影響因素。 方法： 分別選擇本院早產(chǎn)兒重癥監(jiān)護中心2012年01月至2012年12月期間收治入院的胎齡為33周-36周且出生時間小于12小時的存在胎膜早破因素的早產(chǎn)新生兒（胎膜早破組）以及無胎膜早破因素的非感染性疾病早產(chǎn)新生兒（非胎膜早破組）做為研究對象。所有患兒入院后立即經(jīng)橈動脈采血進行血常規(guī)、C反應蛋白（CRP）、血培養(yǎng)（blood culture）及降鈣素原（PCT）檢查。胎膜早破組患兒根據(jù)白細胞計數(shù)（WBC）、未成熟中性粒細胞/中性粒細胞（I/T值）、血小板計數(shù)（PLT）、C反應蛋白、血培養(yǎng)及臨床表現(xiàn)分為3組：重癥感染組（包括革蘭氏陽性菌敗血癥組、革蘭氏陰性菌敗血癥組、真菌敗血癥組、化膿性腦膜炎組）、普通感染組（包括新生兒肺炎、新生兒臍炎）及非感染組（有胎膜早破，感染指標正常）。非胎膜早破組的非感染性疾病患兒包括新生兒顱內出血組（ICH組）、新生兒呼吸窘迫綜合癥組（NRDS組）、新生兒窒息組及對照組（包括單純早產(chǎn)兒、新生兒黃疸）。動態(tài)監(jiān)測各組患兒血常規(guī)、C反應蛋白、血培養(yǎng)、降鈣素原等感染指標，并比較各組患兒降鈣素原濃度，通過統(tǒng)計軟件分析各組早產(chǎn)新生兒的血清降鈣素原濃度以研究不同疾病對早產(chǎn)新生兒血清降鈣素原濃度的影響。 結果： 1.同目前教科書及參考文獻推薦的血清降鈣素原濃度（0.5ng/ml）相比，，早產(chǎn)新生兒生后血清降鈣素原濃度有生理性升高（1.07±0.76ng/ml）。 2.存在胎膜早破因素的非感染組早產(chǎn)兒生后降鈣素原的升高水平高于非胎膜早破非感染疾病早產(chǎn)兒（分別為：2.91±3.02ng/ml及1.07±0.76ng/ml， P0.05）。 3.存在胎膜早破因素的普通感染組早產(chǎn)兒降鈣素原水平較存在胎膜早破因素的非感染組早產(chǎn)兒無明顯差異（分別為：2.92±3.02ng/ml及2.91±3.02ng/ml， P0.05）。 4.重癥感染組早產(chǎn)兒降鈣素原較普通感染組及非感染組早產(chǎn)兒降鈣素原水平升高明顯（分別為：9.23±5.87ng/ml、2.92±3.02ng/ml及2.91±3.02ng/ml， P0.05）。 5.新生兒顱內出血組、新生兒呼吸窘迫綜合癥組、新生兒窒息組降鈣素原水平較對照組均升高（分別為：2.12±0.99ng/ml、2.28±1.09ng/ml、3.64±3.17ng/ml及1.07±0.76ng/ml， P0.05）。 結論： 1.早產(chǎn)兒生后降鈣素原濃度有生理性升高。 2.胎膜早破可導致早產(chǎn)兒生后降鈣素原濃度升高。 3.降鈣素原在早產(chǎn)兒普通感染中升高不明顯。 4.重癥感染早產(chǎn)兒降鈣素原可明顯升高。 5.新生兒顱內出血、新生兒呼吸窘迫綜合癥、新生兒窒息可導致早產(chǎn)兒新生兒降鈣素原濃度升高。
[Abstract]:Objective: to study the influencing factors of serum procalcitonin (PCT) in preterm neonates. Methods: premature newborns with premature rupture of membranes were selected from January 2012 to December 2012 in our hospital from January 2012 to December 2012. The gestational age was 33 weeks to 36 weeks and the birth time was less than 12 hours. Infants (premature rupture of membranes) and preterm neonates without premature rupture of membranes (non-premature rupture of membranes) were studied. All the children were collected from radial artery immediately after admission for blood routine C-reactive protein (CRP), blood culture (blood culture) and procalcitonin (PCT) examination. According to white blood cell count (WBC), immature neutrophil / neutrophil (I / T), platelet count (PLT) and C-reactive protein, blood culture and clinical manifestations of premature rupture of membranes group were divided into three groups: severe infection group (including Gram-positive septicemia group). Gram-negative bacillary septicemia group, fungal septicemia group, suppurative meningitis group), common infection group (including neonatal pneumonia, neonatal umbilical cord) and non-infection group (premature rupture of membranes, normal infection index). The non-infective diseases in non-fetal membrane premature rupture group included neonatal intracranial hemorrhage (ICH), neonatal respiratory distress syndrome (NRDS), neonatal asphyxia and control group (including simple premature infants, neonatal jaundice). Serum C-reactive protein (CRP), blood culture, procalcitonin were dynamically monitored, and the concentration of procalcitonin in each group was compared. In order to study the effect of different diseases on serum procalcitonin concentration of preterm neonates, the serum procalcitonin concentration of preterm newborns was analyzed by statistical software. Results: 1. Compared with the serum procalcitonin concentration (0.5ng/ml) recommended by textbooks and references at present, the serum procalcitonin concentration of preterm newborns increased physiologically (1.07 鹵0.76ng/ml). 2. The level of procalcitonin in preterm infants with premature rupture of membranes was higher than that of premature infants without premature rupture of membranes (1: 2.91 鹵3.02ng/ml and 1.07 鹵0.76 ng / ml, P0.05). There was no significant difference in procalcitonin level in preterm infants with premature rupture of fetal membranes compared with non-infected infants with premature rupture of membranes (1: 2.92 鹵3.02ng/ml and 2.91 鹵3.02 ng / ml, P0.05). The level of procalcitonin in preterm infants in severe infection group was significantly higher than that in normal infection group and non-infection group (2.92 鹵2.92 鹵3.02ng/ml and 2.91 鹵3.02 ng / ml, respectively, P0.05). The levels of procalcitonin in neonatal intracranial hemorrhage group, neonatal respiratory distress syndrome group and neonatal asphyxia group were significantly higher than those in control group (2.12 鹵0.99ng / ml 2.28 鹵1.09ng / ml 3.64 鹵3.17ng/ml and 1.07 鹵0.76ng / ml, P0.05). Conclusion: 1. The procalcitonin concentration in preterm infants was increased physiologically. 2. 2. Premature rupture of membranes can lead to the increase of procalcitonin concentration in preterm infants. The increase of procalcitonin in preterm infants was not significant. 4. 4. Procalcitonin was significantly increased in severe infection preterm infants. Neonatal intracranial hemorrhage, neonatal respiratory distress syndrome, neonatal asphyxia can lead to premature neonatal calcitonin concentration.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R722.6

【參考文獻】

相關期刊論文 前9條

1 劉新菊;代聰偉;唐增軍;;未足月胎膜早破潛伏期與新生兒預后的關系[J];河北醫(yī)藥;2011年01期

2 徐愛蕾;王為;;降鈣素原檢測方法學和臨床意義的研究進展[J];臨床軍醫(yī)雜志;2012年01期

3 馬莉;孫光偉;許s

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