血清降钙素源和超敏C反应蛋白在新生儿感染性疾病早期诊断中的应用

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[目的]探讨PCT在新生儿感染性疾病早期诊断中的应用价值。[方法]对某院收治的70例疑似新生儿感染患儿进行降钙素源(PCT)和超敏C反应蛋白(hs-CRP)测定,并以血培养结果为诊断感染的金标准,分析PCT、hs-CRP的灵敏度、特异度和阳性预测值。[结果]重症组、局部组和对照组的PCT阳性率分别为87.5%、63.2%和14.0%,3组间两两比较差异均有统计学意义(P﹤0.01);细菌组、非细菌组的PCT阳性率分别为95.6%、28.0%,与对照组3组间两两比较,仅非细菌组与对照组差异无统计学意义(P﹥0.05)。重症组、局部组和对照组的hs-CRP阳性率分别为56.3%、39.5%和22.0%,3组间两两比较仅重症组与对照组差异有统计学意义(P﹤0.01);细菌组、非细菌组阳性率分别为57.8%、44.0%,差异无统计学意义(P﹥0.05)。以≥0.5ng/ml为标准,PCT敏感度为87.8%,特异度为66.7%;以≥2ng/ml为标准,PCT敏感度为71.4%,特异度为90.5%。hs-CRP敏感度为61.2%,特异度为76.2%。[结论]PCT具有较高的敏感度和特异度,相比hs-CRP优势明显,对新生儿感染性疾病尤其是重症感染具有重要的早期诊断价值,也是评估疗效和预后的可靠指标。 [Objective] To investigate the value of PCT in the early diagnosis of neonatal infectious diseases. [Methods] 70 cases of suspected neonatal infection in a hospital were tested for calcitonin source (PCT) and high-sensitivity C-reactive protein (hs-CRP). Blood culture results were used as the gold standard for diagnosis of infection. PCT, hs-CRP sensitivity, specificity and positive predictive value. [Results] The positive rates of PCT in severe group, local group and control group were 87.5%, 63.2% and 14.0%, respectively, with statistical significance (P <0.01). The bacterial group, non-bacterial group The positive rate of PCT was 95.6% and 28.0% respectively. There was no significant difference between the control group and the control group (P> 0.05). The positive rates of hs-CRP in severe group, local group and control group were 56.3%, 39.5% and 22.0%, respectively. There was significant difference between the severe group and the control group (P <0.01) , The non-bacterial group positive rate was 57.8%, 44.0%, the difference was not statistically significant (P> 0.05). The PCT sensitivity was 87.8% and the specificity was 66.7% with ≥ 0.5 ng / ml as the standard. The sensitivity and specificity of PCT were 71.4% and 90.5%, respectively. hs-CRP sensitivity was 61.2%, specificity was 76.2%. [Conclusion] PCT has higher sensitivity and specificity, and has obvious advantages over hs-CRP. It has important early diagnostic value for neonatal infectious diseases, especially severe infections, and is also a reliable indicator to evaluate curative effect and prognosis.
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