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目的探讨C-反应蛋白(CRP)在早产儿院内感染诊断中的应用价值。方法住院250例早产儿(≤35周)院内感染监测中,动态检测其双-单倍CRP水平,同期测定血白细胞总数(WBC)、杆状核白细胞比例。其结果进行敏感度(SE)、特异度(SP)、预测值(PV)、似然比(LR)、准确度(AC)、误诊率(α)、漏诊率(β)、统计学参数Kappa值分析。结果早产儿存在院内感染时CRP升高明显,双-单倍血CRP的SE、AC值分别为95.8%,98.4%/83.3%,97.2%,高于WBC、杆状核WBC各值水平; 双-单倍血CRP的α、β值分别为1.3%,4.2%/1.3%,16.7%,低于WBC、杆状核WBC 各值水平;双一单倍血CRP的Kappa值均>0.75,Kappa值:双倍血CRP(0.911)>单倍血CRP(0.836)>WBC(0.514)>杆状核WBC(0.467);双倍血CRP检测P<0.05有统计学差异。结论在早产儿院内感染的诊断中,CRP值升高明显,对诊断院内感染灵敏,特别是双倍血标本CRP值升高更为精确、灵敏,具有较高的临床使用价值。
Objective To investigate the value of C-reactive protein (CRP) in the diagnosis of nosocomial infection in premature infants. Methods During the nosocomial infection monitoring of 250 preterm infants (≤35 weeks) in hospital, the level of double-haplotype CRP was detected dynamically. The number of white blood cells (WBC) and the percentage of rod-like cells were measured during the same period. The results were analyzed for sensitivity (SE), specificity (SP), predictive value (PV), likelihood ratio (LR), accuracy (AC), misdiagnosis rate (α), misdiagnosis rate (β), statistical parameter Kappa Value analysis. Results The serum CRP levels in preterm infants with nosocomial infection were significantly increased. The SE and AC values in CRP were 95.8%, 98.4% / 83.3% and 97.2%, respectively, which were higher than those in WBC and WBC. The values of α and β in single blood of CRP were 1.3%, 4.2% / 1.3% and 16.7%, respectively, which were lower than those of WBC and WBC. The Kappa values of CRP were both 0.75 and Kappa Values: double blood CRP (0.911)> single blood CRP (0.836)> WBC (0.514)> rod WBC (0.467); double blood CRP test P <0.05 statistically significant. Conclusion In the diagnosis of nosocomial infection in preterm neonates, the CRP value rises obviously. It is more accurate and sensitive to diagnose the nosocomial infection, especially the double blood sample CRP value, which has high clinical value.