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目的评价降钙素原(PCT)诊断新生儿败血症的临床价值。方法选择入院日龄为3~28 d的新生儿。根据新生儿败血症诊断标准进行分组:对照组、局部感染组、单纯败血症组、败血症合并严重并发症组。按预先设定时间段对研究对象采血以分别进行PCT、超敏C反应蛋白(hsCRP)、血培养及血常规检测,并对资料进行统计分析。结果共入选76例,对照组20例、局部感染组15例、单纯败血症组29例、败血症合并严重并发症组12例。PCT作为新生儿败血症的诊断指标,其灵敏度、特异度、阳性预测值、阴性预测值分别为82.9%、97.1%、97.1%、82.9%,优于hsCRP(80.4%、88.6%、89.2%、79.9%)。与hsCRP相比,PCT与败血症的严重程度相关性更强(rPCT=0.859,rhsCRP=0.782),与败血症临床情况更相符(P<0.05)。结论血清PCT作为实验室检测指标,有助于新生儿败血症的临床诊断及治疗。
Objective To evaluate the clinical value of procalcitonin (PCT) in the diagnosis of neonatal sepsis. Methods The neonates were selected on admission from 3 to 28 days old. According to diagnostic criteria of neonatal sepsis group: control group, local infection group, simple sepsis group, sepsis with severe complications group. Blood samples were collected from subjects according to pre-set time period to detect PCT, hsCRP, blood culture and blood routine respectively, and the data were statistically analyzed. Results A total of 76 patients were selected, 20 patients in control group, 15 patients in local infection group, 29 patients in simple sepsis group and 12 patients in severe sepsis and severe complications group. The sensitivity, specificity, positive predictive value and negative predictive value of PCT as neonatal sepsis were 82.9%, 97.1%, 97.1% and 82.9%, respectively, better than hsCRP (80.4%, 88.6%, 89.2%, 79.9 %). Compared with hsCRP, PCT was more associated with the severity of sepsis (rPCT = 0.859, rhsCRP = 0.782), more in line with the clinical status of sepsis (P <0.05). Conclusion Serum PCT as a laboratory test indicators, contribute to the clinical diagnosis and treatment of neonatal sepsis.