摘要
目的评估出生早期不同时段血清降钙素原（procalcitonin，PCT）对新生儿早发细菌感染的诊断和治疗价值。方法将195例有宫内感染高危因素的新生儿根据感染结局分为细菌感染组24例及非感染组171例，测定出生2h内，6～12h，12-36h及大于48h新生儿血清PCT、C-反应蛋白（C-reactiveprotein，CRP）及外周血白细胞含量，分析不同时段PCT诊断早发感染的敏感度、特异度，及其对疗效的判断。结果出生2h内细菌感染组PCT、CRP及白细胞阳性率比较差异均无统计学意义（P〉0．05）；出生6～12h当PCT以2ng/ml为阈值时，其诊断细菌感染的敏感度为91．7％，特异度为86．5％，较CRP及白细胞具有更高的敏感度；出生12～36h是PCT的生理性高峰期，不同阈值的PCT均不能同时有较高的敏感度及特异度，当PCT以0．5neVml、2ng／ml以及10ng／ml为阈值时，其敏感度分别为100％、91．7％及75．0％，特异度分别为5．8％、53．8％及95．9％。结论出生6～12h测定PCT，并且以2ng／ml为阈值时，对诊断早发细菌感染有较高的敏感度及特异度，尽量避开PCT的生理性高峰期（出生12-36h）测定PCT浓度，该时期诊断细菌感染的PCT阈值尚需进一步探讨。
Objective To evaluate the value of procalcitonin（PCT） in different periods for diagno- sis of early-onset of neonatal bacterial infection. Methods One hundred and ninety-five newborns with intra- uterine infection risk factors were divided into two groups： infection group （24 cases） and non-infection group（ 171 cases）. The levels of PCT, C-reactive protein（CRP） and WBC were measured in 2 hours,6 to 12 hours, 12 to 36 hours and more than 48 hours after birth. The sensitivity and specificity of PCT in different periods in the diagnosis of early-onset infection were analyzed. Results There were no significant differ- ences in the positive rate of PCT, CRP and WBC in infection group in 2 hours after birth （ P 〉 0. 05 ）. The sensitivity and specificity for diagnosis of early-onset infection of PCT were 91.7% and 86. 5% at 6 to 12 hours after birth,which were higher than those of CRP and WBC. After birth in 12 to 36 hours was the physiologic peak of PCT, so it couldn＇t have higher sensitivity and specificity. According to threshold of 0. 5 ng/m1,2 ng/ml, and 10 ng/ml for PCT, the sensitivity was 100%, 91.7% and 100% respectively, and the specificity was 5.8% ,53.8% and 95.9% respectively. Conclusion PCT in 6 to12 hours after birth,ac- cording to threshold of 2 ng/ml, can reach higher sensitivity and specificity for diagnosis of early-onset neo- natal bacterial infection.
出处
《中国小儿急救医学》
CAS
2016年第4期227-230,共4页
Chinese Pediatric Emergency Medicine
关键词
降钙素原
C-反应蛋白
早发感染
Procalcitonin
C-reactive protein
Early-onset infection
作者简介
通信作者：林雅茵，Email：linyy0806@163．com
