新生儿肺炎合并脓毒症患儿检测血清降钙素原和高敏C反应蛋白的临床价值

doi:10.3969/j.issn.1673-8640.2014.10.004

摘要/Abstract

摘要：

目的评价新生儿肺炎合并脓毒症患儿检测血清降钙素原(PCT)、高敏C反应蛋白(hs-CRP)的临床价值,并探讨其血清含量与新生儿脓毒症严重程度的相关性。方法分别采用免疫荧光法和散射比浊法测定216例新生儿肺炎患儿(其中非脓毒症119例、轻度脓毒症69例、严重脓毒症28例)血清PCT和hsCRP含量。绘制受试者工作特征(ROC)曲线,分析PCT、hs-CRP对肺炎合并轻度脓毒症和严重脓毒症的诊断价值。结果非脓毒症、轻度脓毒症和严重脓毒症患儿PCT、hs-CRP水平依次升高,各组间差异均有统计学意义(P均<0.01)。PCT、hs-CRP诊断肺炎合并轻度脓毒症和严重脓毒症的ROC曲线下面积分别为0.853、0.772 。PCT和hs-CRP分别以 ≥2 ng/mL和≥55 mg/L为截点诊断肺炎合并严重脓毒症的性能最佳,敏感性分别为71.43%和82.14%、特异性分别为75.00%和53.57%;若两者联合诊断,敏感性和特异性分别为89.29%和85.71% 。PCT和hs-CRP在新生儿肺炎合并脓毒症患儿治疗前后差异有统计学意义(P<0.05)。结论 PCT和hs-CRP对判断新生儿肺炎合并脓毒症严重程度有较高的应用价值,其中PCT比hs-CRP更能反映脓毒症的严重程度。联合检测PCT和hs-CRP对新生儿肺炎合并脓毒症的早期诊断、疗效观察和预后判断有较高的价值。

关键词: 降钙素原, 高敏C反应蛋白, 新生儿肺炎, 脓毒症

Abstract:

Objective To assess the clinical significance of serum procalcitonin(PCT) and high-sensitivity C reactive protein(hs-CRP) in neonatal pneumonia and sepsis patients, and to investigate the correlation of the levels of serum PCT and hs-CRP with the severity of neonatal sepsis. Methods A total of 216 neonatal pneumonia patients were enrolled and classified into 3 groups, including 119 cases of non-sepsis, 69 cases of mild sepsis and 28 cases of severe sepsis. The levels of serum PCT and hs-CRP were determined by immunofluorescence and turbidimetric method. By receiver operating characteristic (ROC) curve, the diagnosis significances of PCT and hs-CRP for mild sepsis and severe sepsis with pneumonia were analyzed. Resutls PCT and hs-CRP levels in non-sepsis, mild sepsis and severe sepsis patients increased, and there was statistical significance (P<0.01). The areas under ROC curves of PCT and hs-CRP for the diagnosis of pneumonia with mild sepsis and severe sepsis were 0.853 and 0.772. PCT ≥ 2 ng/mL and hs-CRP ≥ 55 mg/L were optimal cut-off values for the diagnosis of pneumonia with severe sepsis, the sensitivities were 71.43% and 82.14%, and the specificities were 75.00% and 53.57%, respectively. If the combined determination was performed, the sensitivity and specificity were 89.29% and 85.71%. PCT and hs-CRP levels were statistically significant before and after the treatment for neonatal pneumonia and sepsis patients (P<0.05). Conclusions PCT and hs-CRP have high application significance to judge the neonatal pneumonia and sepsis severity, and PCT can reflect the sepsis more clearly than hs-CRP. The combined determination of PCT and hs-CRP has high significance for the early diagnosis, observation of curative effect and prognosis on neonatal pneumonia and sepsis.

Key words: Procalcitonin, High-sensitivity C reactive protein, Neonatal pneumonia, Sepsis

中图分类号:

R446.62

曹艳林, 刘德贝, 夏先考. 新生儿肺炎合并脓毒症患儿检测血清降钙素原和高敏C反应蛋白的临床价值[J]. 检验医学, 2014, 29(10): 1000-1003.

CAO Yanlin, LIU Debei, XIA Xiankao.. The clinical significance of serum procalcitonin and high-sensitivity C reactive protein in neonatal pneumonia and sepsis patients[J]. , 2014, 29(10): 1000-1003.

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