李维春 张克昌 杨续 王圣东
[摘要]意图 讨论降钙素原（PCT）和C反响蛋白（CRP）检测在重生儿败血症前期确诊中的临床价值。办法 选取2015年1月～2016年12月入住南京儿童医院滁州分院的113例重生兒作为研讨目标，依照重生儿败血症的确诊规范及是否发作感染，将患儿分为败血症组（91例）和非感染组（22例）。比较败血症组与非感染组重生儿的CRP和PCT水平，比较32例败血症患儿医治前后的PCT水平，剖析CRP和PCT在确诊重生儿败血症中的敏感度、特异性、阳性猜测值及阴性猜测值。成果 败血症组患儿的CRP、PCT水平高于非感染组，差异均有统计学含义（P<0.05）。败血症组32例患儿医治后的PCT水平明显低于医治前，差异有统计学含义（P<0.01）。PCT≥2 μg/L确诊重生儿败血症的敏感度为74.74%，特异性为100.00%，CRP≥8 mg/L确诊重生儿败血症的敏感度为54.95%，特异性为81.82%。定论 降钙素原和C反响蛋白的检测在重生儿败血症前期确诊及效果点评中具有必定的临床价值，联合检测降钙素原和C反响蛋白有助于进步确诊的敏感度和特异度。
[关键词]降钙素原；C反响蛋白；重生儿败血症；确诊
[中图分类号] R446.62 [文献标识码] A [文章编号] 1674-4721（2018）2（a）-0109-03
[Abstract]Objective To explore the clinical value of dection procalcitonin （CRP） and C reactive protein （PCT） in early diagnosis neonatal sepsis.Methods 113 newborn cases were collected in Chuzhou branch of Nanjing children′s hospital from January 2015 to December 2016 and were selected as the research objects and divided into the sepsis group （91 cases） and non-infected group （22 cases） according to the diagnostic criteria for neonatal septicemia and whether infection was occurred.The levels of PCT and CRP between the sepsis group and non-infected group were compared，the levels of PCT of 32 children in the sepsis group before and after treatment were compared，the sensitivity，specificity，positive predictive value and negative predictive value of PCT and CRP in the diagnosis of neonatal sepsis were analyzed.Results The levels of the PCT and CRP in the sepsis group were higher than those in the non-infected group，and the differences were statistically significant （P<0.05）.The PCT level of 32 children with septicemia after treament was significantly lower than before treatment，and the difference was statistically significant （P<0.01）.The sensitivity of PCT≥2 μg/L to the diagnosis of neonatal sepsis was 74.74%，specificity was 100.00%，the sensitivity of CRP≥8 mg/L to the diagnosis of neonatal sepsis was 54.95%，and the specificity was 81.82%.Conclusion There are clinical value of detection CRP and PCT in early diagnosis neonatal sepsis and the effect of treatment.Detected PCT combine with CRP were valuable to improve sensitivity and specificity in diagnosis neonatal sepsis.
[Key words]Procalcitonin；C reactive protein；Neonatal sepsis；Diagnosis
重生儿败血症（neonatal septicemia），指的是重生儿期细菌或其它病原微生物侵入血循环并在其间成长繁衍，发生毒素所形成的全身性感染，是足月和早产重生儿发病和及逝世的主要原因之一[1]，依据发病时刻为边界（出世后7 d），分为早发型败血症（early-onset sepsis，EOS）与晚发型败血症（late-onset sepsis，LOS）。2000年出书的16版Nelson教科书将真菌、病毒及原虫均已列入重生儿败血症的病原体。迄今为止，血培育仍然是重生儿败血症确诊的金规范，但由于其培育所需时刻长、阳性率低，易呈现假阴性和假阳性，往往不能到达前期确诊的意图[2-3]。本研讨选取入住南京儿童医院滁州分院的113例重生儿作为研讨目标，经过调查重生儿败血症患儿降钙素原和C反响蛋白水平的改变，讨论其在重生儿败血症前期确诊及效果点评中的价值，现报导如下。
