【摘要】：目的比較出生后72 h內(nèi)不同日齡降鈣素原(PCT)與C反應(yīng)蛋白(CRP)對新生兒早發(fā)型敗血癥(EONS)的診斷價值。方法分析2008年9月至2015年12月新生兒無嚴(yán)重并發(fā)癥的EONS組96例(包括2例確診敗血癥,94例為臨床診斷敗血癥),同時期無感染對照組170例。266例新生兒共收集血樣本605份。分別檢測生后72 h內(nèi)各日齡區(qū)間EONS組及對照組血清PCT于與CRP水平。比較PCT及CRP在出生后1~12 h、13~24 h、25~48 h與49~72 h不同日齡區(qū)間診斷EONS的診斷閾值、敏感性、特異性及曲線(ROC)下面積。結(jié)果在生后72 h內(nèi)EONS組各日齡區(qū)間的血清PCT和CRP水平均高于對照組,差異均有統(tǒng)計學(xué)意義(P0.05)。在出生后1~12 h、13~24 h、25~48 h、49~72 h不同日齡區(qū)間,PCT和CRP診斷EONS的診斷閾值分別對應(yīng)為PCT 0.45、1.885、0.995、0.51,CRP 3.185、6.29、8.615、10.27、敏感性分別為PCT 84.2%、73.5%、82.4%、83.3%,CRP 68.4%、58.8%、54.3%、59.1%,特異性分別為PCT 74.4%、75%、74.1%、79.2%,CRP 82.1%、89.7%、93.9%、100%,ROC曲線下面積分別為PCT 0.767、0.754、0.755、0.8,CRP 0.773、0.8、0.815、0.789。結(jié)論在出生后72 h內(nèi),PCT與CRP對診斷無嚴(yán)重并發(fā)癥的EONS各有日齡相關(guān)的診斷閾值,并均有中度的診斷準(zhǔn)確性。兩者在診斷EONS敏感性和特異性各有優(yōu)勢。PCT敏感性高于CRP可能更有助于EONS的早期篩查,而CRP的特異性高于PCT,但敏感性有限,對ENOS診斷可能有一定的局限性。
[Abstract]:Objective to compare the diagnostic value of procalcitonin (PCT) and C-reactive protein (CRP) between procalcitonin (PCT) and C-reactive protein (CRP) in the early onset of neonatal septicemia (EONS) within 72 hours after birth. Methods from September 2008 to December 2015, 96 cases of EONS group (including 2 cases of septicemia and 94 cases of clinically diagnosed septicemia) and 170 cases of non-infected control group from September 2008 to December 2015 were analyzed. A total of 605 blood samples were collected from 266 newborns. The levels of serum PCT and CRP were measured in EONS group and control group within 72 hours after birth. To compare the diagnostic threshold, sensitivity, specificity and area under curve (ROC) between PCT and CRP in different ages of EONS at 1: 12 h, 1324 h, 2548 h and 4972 h. Results the levels of serum PCT and CRP in EONS group were significantly higher than those in control group within 72 hours after birth (P0.05). The diagnostic thresholds of PCT and CRP for the diagnosis of EONS were PCT 0.45V 1.885U 0.995C 3.185C 3.185U 6.296.298.615cr 10.27, and the sensitivity of PCT 84.23.73.5%, respectively, at 1: 12h / 1324h, 2548h / 48h and 497h / 772 h after birth, and the diagnostic thresholds of PCT and CRP for EONS diagnosis were respectively 0.45 / 1.885and 0.995c / 0.995. the sensitivity was 84.23.5. 82.4 including 83.3% of RP68.4 and 58.8% of 54.3 and 54.1, the specificity of which is PCT 74.4 and 75.75 and 74.1, respectively, and the score of 79.2CRP is 82.1and the score is 89.77.The score is 93.90.The specific value is PCT 74.4and 74.4and 79.2CR82.1and the score is 93.9. The area under ROC curve is PCT 0.7670.754U 0.7550.8CRP 0.773U 0.80.150.89. Conclusion within 72 hours after birth, both PCT and CRP have age-related diagnostic thresholds for EONS without severe complications, and both have moderate diagnostic accuracy. The sensitivity of PCT is higher than that of CRP, while the specificity of CRP is higher than that of PCT, but the sensitivity of CRP is limited, which may be limited to the diagnosis of ENOS.
【作者單位】： 廣州軍區(qū)廣州總醫(yī)院小兒科;
【基金】：2013年度廣東省產(chǎn)業(yè)技術(shù)研究與開發(fā)專項資金項目(編號:2013B03180009)
【分類號】：R722.131
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本文編號：2364397