降钙素原检测对新生儿败血症早期诊断治疗及病情评估的临床意义(1)
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[摘要] 目的：探讨降钙素原(PCT)对新生儿败血症的早期诊断及病情评估的价值。方法：将2008年7月～2010年7月我院收治的新生儿败血症55例作为研究对象，其中合并休克的20例作为重症组，其余35例作为轻症组，将同期住院非败血症新生儿40例作为对照组，用免疫色谱法对比检测新生儿败血症与其他新生儿患者在入院时及住院抗生素治疗1周后血浆PCT及C反应蛋白(CRP)浓度的变化。结果：新生儿败血症患者入院时(急性期)PCT较对照组明显升高[(15.6±7.1)μg/L vs (0.8±0.4)μg/L](P<0.01)]，经抗生素治疗1周后下降接近正常[(1.2±1.0)μg/L]，与对照组比较差异无统计学意义(P>0.05)；PCT的敏感性、特异性(89.0%、82.4%)均高于CRP(78.2%、69.6%)；新生儿败血症PCT重症较轻症患者明显增高(P<0.01)。结论：PCT的检测对新生儿败血症的早期诊断、病情及治疗效果的评估有一定价值。
[关键词] 降钙素原；新生儿败血症；诊断；病情评估
[中图分类号] R722.13+1[文献标识码]A[文章编号]1673-7210(2011)04(b)-026-03
The clinical significance of monitoring PCT on early diagnosis and treatment and disease assessment in neonatal sepsis
LI Shuli, WANG Beihai, SUN Hecai
Department of Paediatrics, the Second Hospital Attached to He′nan Technology University, Luoyang 471000, China
[Abstract] Objective: To explore the diagnostic and disease assessment value of monitoring serum PCT in neonatal sepsis before and after treatment. Methods: 55 cases with neonatal sepsis cured in our hospital from July 2008 to July 2010 were selected, in which 20 cases with shock as severe group and the rest without shock as mild group, at the same time 40 cases without neonatal sepsis were selected as control group. Serum PCT and CRP in neonatal sepsis and neonates without infection were tested on first day in hospital and after one week′s treatment of antibiotics by immunity chromatography. Results: The level of PCT in neonatal sepsis was (15.6±7.1) μg/L, which was higher than PCT level [(0.8±0.4) μg/L] that in without neonatal sepsis (P<0.01). After appropriate treatment by antibiotics, PCT decreased almost to normal level [(1.2±1.0) μg/L], and there was no statistical difference between the two groups (P>0.05). The sensibility and specificity of PCT (89.0%, 82.4%) were higher than CRP(78.2%, 69.6%). The level of PCT in severe neonatal sepsis was significantly higher than that in mild ones(P<0.01). Conclusion: Determination of PCT is valuable for the diagnosis and treatment of neonatal sepsis.
[Key words] PCT; Neonatal sepsis; Diagnose; Disease assessment ......
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