脐血降钙素原对新生儿早发败血症诊断价值研究

发布时间：2018-11-23 11:03

【摘要】：目的观察脐血降钙素原(PCT)对新生儿早发败血症(EOS)的诊断价值。方法收集2016年1月至2016年10月于中国医科大学本溪中心医院住院并分娩的孕妇及其活产新生儿资料,记录母亲孕期及新生儿一般情况,将新生儿按照胎龄分为早产组和足月组,病例组分别记为早产EOS组和足月EOS组,并将同期住院相应胎龄无感染者分别作为早产和足月对照组。分别测定母亲脐血PCT、血白细胞(WBC)、C-反应蛋白(CRP);新生儿出生后动态测定血PCT、WBC、CRP,比较脐血PCT及各组新生儿血液学检测结果与EOS的关系。结果早产EOS组PCT[(7.82±6.60)μg/L]明显高于早产对照组[(0.29±0.15)μg/L,t=4.56,P0.001],足月EOS组PCT[(6.73±5.43)μg/L]明显高于足月对照组[(0.42±0.22)μg/L,t=2.85,P=0.036]。早产EOS组CRP(第3天)[(16.55±9.41)mg/L]明显高于早产对照组[(3.43±1.65)mg/L,t=5.56,P0.001],足月EOS CRP(第3天)[(22.66±9.07)mg/L]明显高于足月对照组[(3.96±1.71)mg/L),t=5.04,P=0.004]。EOS组与对照组在母亲年龄、母亲妊娠高血压疾病、妊娠期糖尿病、剖宫产、胎龄、婴儿性别、出生体重及胎次因素方面比较,差异无统计学意义。产前感染、产前抗生素应用、胎膜早破、羊水污染、出生窒息、发热或者体温不升、心率增快、呼吸暂停或者呼吸困难因素方面比较,EOS组明显高于对照组(P0.05)。足月儿EOS组血培养阳性率与早产儿血培养阳性率比较(χ~2=0.663,P=0.416),差异无统计学意义。结论脐血PCT可以早期预测新生儿EOS,对EOS有诊断价值。
[Abstract]:Objective to evaluate the diagnostic value of procalcitonin (PCT) (PCT) in neonatal premature septicemia (EOS). Methods from January 2016 to October 2016, pregnant women hospitalized and delivered in Benxi Central Hospital of China Medical University and their newborns born alive were collected and recorded. The newborns were divided into preterm group and term group according to gestational age. The cases were recorded as preterm EOS group and term EOS group, and no infection at the corresponding gestational age in the same period were taken as preterm delivery and term control group respectively. Serum (WBC), C-reactive protein (CRP); (WBC), C-reactive protein (CRP);) in maternal umbilical cord blood (PCT,) was measured to compare the relationship between PCT in umbilical cord blood and the results of hematology and EOS in newborns. Results PCT in premature EOS group [(7.82 卤6.60) 渭 g / L] was significantly higher than that in premature birth control group [(0.29 卤0.15) 渭 g / L] (4.56 渭 g / L). PCT in term EOS group [(6.73 卤5.43) 渭 g / L] was significantly higher than that in term control group [(0.42 卤0.22) 渭 g / L ~ 2.85 渭 g / L]. CRP in premature EOS group (3 days) [(16.55 卤9.41) mg/L] was significantly higher than that in premature birth control group [(3.43 卤1.65) mg/L,t=5.56,P0.001]. The third day of EOS CRP ([(22.66 卤9.07) mg/L] was significantly higher than that of the term control group [(3.96 卤1.71) mg/L], tachycardia was 5.04% P0. 004. The age of mother and pregnancy hypertension in EOS group and control group were significantly higher than those in the term group [(3.96 卤1.71) mg/L]. There was no significant difference in gestational diabetes mellitus, cesarean section, gestational age, sex, birth weight and birth order. Antepartum infection, antepartum antibiotic application, premature rupture of membranes, amniotic fluid contamination, birth asphyxia, fever or body temperature not rising, heart rate increasing, apnea or dyspnea factors, EOS group was significantly higher than the control group (P0.05). There was no significant difference between the positive rate of blood culture in term EOS group and that in premature infants (蠂 ~ 2 ~ (0.663) P ~ 0. 416). Conclusion umbilical cord blood PCT can early predict neonatal EOS, in diagnosis of EOS.
【作者单位】：中国医科大学附属盛京医院儿科;
【分类号】：R722.131

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