早产新生儿血清降钙素原浓度影响因素的研究

发布时间：2018-06-29 11:56

本文选题：早产儿 + 新生儿　；参考：《大连医科大学》2013年硕士论文

【摘要】：目的：研究早产新生儿血清降钙素原（Procalcitonin，PCT)的影响因素。方法：分别选择本院早产儿重症监护中心2012年01月至2012年12月期间收治入院的胎龄为33周-36周且出生时间小于12小时的存在胎膜早破因素的早产新生儿（胎膜早破组）以及无胎膜早破因素的非感染性疾病早产新生儿（非胎膜早破组）做为研究对象。所有患儿入院后立即经桡动脉采血进行血常规、C反应蛋白（CRP）、血培养（blood culture）及降钙素原（PCT）检查。胎膜早破组患儿根据白细胞计数（WBC）、未成熟中性粒细胞/中性粒细胞（I/T值）、血小板计数（PLT）、C反应蛋白、血培养及临床表现分为3组：重症感染组（包括革兰氏阳性菌败血症组、革兰氏阴性菌败血症组、真菌败血症组、化脓性脑膜炎组）、普通感染组（包括新生儿肺炎、新生儿脐炎）及非感染组（有胎膜早破，感染指标正常）。非胎膜早破组的非感染性疾病患儿包括新生儿颅内出血组（ICH组）、新生儿呼吸窘迫综合症组（NRDS组）、新生儿窒息组及对照组（包括单纯早产儿、新生儿黄疸）。动态监测各组患儿血常规、C反应蛋白、血培养、降钙素原等感染指标，并比较各组患儿降钙素原浓度，通过统计软件分析各组早产新生儿的血清降钙素原浓度以研究不同疾病对早产新生儿血清降钙素原浓度的影响。结果： 1.同目前教科书及参考文献推荐的血清降钙素原浓度（0.5ng/ml）相比，，早产新生儿生后血清降钙素原浓度有生理性升高（1.07±0.76ng/ml）。 2.存在胎膜早破因素的非感染组早产儿生后降钙素原的升高水平高于非胎膜早破非感染疾病早产儿（分别为：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组早产儿降钙素原水平较存在胎膜早破因素的非感染组早产儿无明显差异（分别为：2.92±3.02ng/ml及2.91±3.02ng/ml， P0.05）。 4.重症感染组早产儿降钙素原较普通感染组及非感染组早产儿降钙素原水平升高明显（分别为：9.23±5.87ng/ml、2.92±3.02ng/ml及2.91±3.02ng/ml， P0.05）。 5.新生儿颅内出血组、新生儿呼吸窘迫综合症组、新生儿窒息组降钙素原水平较对照组均升高（分别为：2.12±0.99ng/ml、2.28±1.09ng/ml、3.64±3.17ng/ml及1.07±0.76ng/ml， P0.05）。结论： 1.早产儿生后降钙素原浓度有生理性升高。 2.胎膜早破可导致早产儿生后降钙素原浓度升高。 3.降钙素原在早产儿普通感染中升高不明显。 4.重症感染早产儿降钙素原可明显升高。 5.新生儿颅内出血、新生儿呼吸窘迫综合症、新生儿窒息可导致早产儿新生儿降钙素原浓度升高。
[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 卤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 卤3.02ng/ml and 1.07 卤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 卤3.02ng/ml and 2.91 卤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 卤2.92 卤3.02ng/ml and 2.91 卤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 卤0.99ng / ml 2.28 卤1.09ng / ml 3.64 卤3.17ng/ml and 1.07 卤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.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R722.6

【参考文献】