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目的:探讨降钙素原(PCT)、白细胞介素-6(IL-6)及C反应蛋白(CRP)对新生儿宫内细菌感染的诊断价值。方法:根据感染结局将2013年3月-2014年9月在我院分娩且有宫内感染高危因素的179例新生儿分为感染组(34例)和无感染组(145例),检测两组新生儿的PCT、IL-6及CRP水平,并比较其对宫内细菌感染的诊断价值。结果:感染组新生儿脐带血PCT、IL-6、CRP水平均高于无感染组,差异有统计学意义(P<0.05)。感染组新生儿各单个指标阳性率、两指标联合检测阳性率高于无感染组,差异均有统计学意义(P<0.05),感染组新生儿PCT、IL-6阳性率高于CRP,PCT+IL-6的阳性率高于PCT+CRP、IL-6+CRP,差异均有统计学意义(P<0.05)。PCT+IL-6的灵敏度、准确率高于单个指标及其他两个指标联合检测,差异均有统计学意义(P<0.05),各项指标检测的特异性比较,差异无统计学意义(P>0.05)。结论:新生儿宫内感染采用脐带血PCT检测具有灵敏度高、特异性好的特点,联合IL-6检测是临床诊断新生儿宫内感染的有效方式。
Objective: To investigate the diagnostic value of procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) in neonatal intrauterine bacterial infection. Methods: According to the infection outcome, 179 newborns with high risk of intrauterine infection who were delivered in our hospital from March 2013 to September 2014 were divided into infection group (34 cases) and non-infection group (145 cases) Group of newborns PCT, IL-6 and CRP levels, and compare their diagnostic value of intrauterine bacterial infection. Results: The levels of cord blood PCT, IL-6 and CRP in neonates with infection were higher than those without infection, the difference was statistically significant (P <0.05). The positive rate of each single index in neonatal infection group was higher than that in non-infected group (P <0.05), and the positive rate of PCT and IL-6 in neonates was higher than that in CRP and PCT + IL-6 was higher than that of PCT + CRP, IL-6 + CRP, the difference was statistically significant (P <0.05). The sensitivity and accuracy of PCT + IL-6 were higher than those of single index and other two indexes (P <0.05), and there was no significant difference in the specificity of each index (P > 0.05). Conclusion: The cord blood PCT detection in neonatal intrauterine infection has the characteristics of high sensitivity and good specificity. Combined with IL-6 detection is an effective way to diagnose neonatal intrauterine infection.