hs-CRP和PCT在诊断新生儿败血症中的应用价值

发布时间：2018-02-28 00:24

本文关键词： 新生儿败血症降钙素原超敏C反应蛋白　出处：《昆明医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：新生儿败血症是严重的细菌感染性疾病,也是临床上较常见的新生儿极危重症之一,是造成新生儿残疾和死亡的主要原因。目前对新生儿败血症的诊断仍缺乏快速而准确的检测手段。我们对入住我院新生儿病房的新生儿进行回顾性分析,以评估PCT(Procalcitonin, PCT)、hs-CRP(high sensitivity C-reactive protein, hs-CRP)等指标在新生儿败血症中的价值,指导败血症的临床诊断和及时正确治疗,降低新生儿死亡率。目的：探讨及评价PCT和hs-CRP对新生儿败血症早期诊断的价值,并与已知的细菌感染标志物进行比较。方法：收集2010年9月至2011年11月我院新生儿室收治的新生儿(日龄3-28天)共183例为研究对象,按最后出院诊断分为败血症组、败血症合并并发症组、局部感染组及非感染组,分别收集临床资料及实验室指标,包括血常规、肌酸激酶混合型同工酶(CK-MB)、hs-CRP、PCT等,对资料进行相关统计学分析,并分别计算各指标的灵敏度、特异度、阳性预测值、阴性预测值及约登指数等。结果：1、PCT与hs-CRP均具有较高的诊断准确性,但PCT有更高的灵敏度、特异度、阳性预测值、阴性预测值及约登指数,在诊断的准确性及真实性上,PCT要较hs-CRP更好； 2、在新生儿败血症的诊断上,PCT与hs-CRP均明显优于白细胞计数及中性粒细胞百分比、血小板的诊断价值(P0.05)； 3、PCT与hs-CRP均与败血症的严重程度呈正相关,但PCT与败血症严重程度的相关性强于hs-CRP; 结论：PCT在新生儿败血症的诊断方面,在灵敏度、特异度、阳性预测值、阴性预测值上更优于hs-CRP,可以作为诊断败血症的参考指标；同时可准确反映败血症的严重程度、是否发生严重并发症等,可用于指导抗生素的使用。
[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.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R722.1

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