不同日龄降钙素原与C反应蛋白对新生儿早发型败血症的诊断价值

发布时间：2018-11-29 07:55

【摘要】：目的比较出生后72 h内不同日龄降钙素原(PCT)与C反应蛋白(CRP)对新生儿早发型败血症(EONS)的诊断价值。方法分析2008年9月至2015年12月新生儿无严重并发症的EONS组96例(包括2例确诊败血症,94例为临床诊断败血症),同时期无感染对照组170例。266例新生儿共收集血样本605份。分别检测生后72 h内各日龄区间EONS组及对照组血清PCT于与CRP水平。比较PCT及CRP在出生后1~12 h、13~24 h、25~48 h与49~72 h不同日龄区间诊断EONS的诊断阈值、敏感性、特异性及曲线(ROC)下面积。结果在生后72 h内EONS组各日龄区间的血清PCT和CRP水平均高于对照组,差异均有统计学意义(P0.05)。在出生后1~12 h、13~24 h、25~48 h、49~72 h不同日龄区间,PCT和CRP诊断EONS的诊断阈值分别对应为PCT 0.45、1.885、0.995、0.51,CRP 3.185、6.29、8.615、10.27、敏感性分别为PCT 84.2%、73.5%、82.4%、83.3%,CRP 68.4%、58.8%、54.3%、59.1%,特异性分别为PCT 74.4%、75%、74.1%、79.2%,CRP 82.1%、89.7%、93.9%、100%,ROC曲线下面积分别为PCT 0.767、0.754、0.755、0.8,CRP 0.773、0.8、0.815、0.789。结论在出生后72 h内,PCT与CRP对诊断无严重并发症的EONS各有日龄相关的诊断阈值,并均有中度的诊断准确性。两者在诊断EONS敏感性和特异性各有优势。PCT敏感性高于CRP可能更有助于EONS的早期筛查,而CRP的特异性高于PCT,但敏感性有限,对ENOS诊断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.
【作者单位】： 广州军区广州总医院小儿科;
【基金】：2013年度广东省产业技术研究与开发专项资金项目(编号:2013B03180009)
【分类号】：R722.131
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