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降钙素原在新生儿感染性疾病早期诊断中的应用
作者:朱玲玲 舒桂华 严语 徐翔 
单位:江苏省苏北人民医院,新生儿科,江苏,扬州,225001
关键词:降钙素原 新生儿感染 早期诊断 
分类号:R722.13, R446.11
出版年·卷·期(页码):2005·24·第六期(398-400)
摘要:

目的:探讨新生儿感染性疾病早期诊断的方法和降钙素原(PCT)在新生儿感染性疾病诊断中的临床意义.方法:对76例疑似新生儿感染患儿,在应用抗生素前测定PCT、C反应蛋白(CRP)、血常规及行血培养,比较它们对细菌感染诊断的敏感性、特异性.结果:(1)血清PCT检测对细菌感染诊断的敏感性为81.36%,特异性为64.71%.(2)CRP对细菌感染诊断敏感性为47.46%,特异性为70.59%;与血清PCT检测结果比较,敏感性有显著差异(P<0.01),特异性无显著差异(P>0.05).(3)白细胞计数或(和)分类异常升高对细菌感染诊断敏感性为52.54%,特异性为52.94%,与血清PCT检测结果比较有显著差异(P<0.05).结论:血清PCT可作为新生儿感染的早期检测指标,其作用优于CRP测定和外周血白细胞计数及分类.通过对PCT水平的动态观察,既可早期诊断、及时治疗新生儿感染性疾病,又可判断感染是否被控制.

Objective To explore the early diagnosis method of neonatal infectious diseases and to investigate the clinical significance of procalcitonin(PCT) applied to neonatal infection.Methods Serum PCT,C-reaction protein(CRP),blood routine and blood culture were measured in a total of 76 infectious neonates before antibiotics were administered.Their sensitivities and specificities for diagnosing bacterial infection were compared.Result(1)Serum PCT sensitivity and specificity for bacterial infection were 81.36%(48/59) and 64.7%(11/17) respectively.(2)CRP sensitivity and specificity for bacterial infection were 47.46%(28/59) and 70.59%(12/17),with a significant difference(P<0.01) of sensitivity and no significant difference(P>0.05) in specificity compared to serum PCT.(3)Sensitivity and specificity for bacterial infection of WBC count and(or) abnormal classification were 52.54%(31/59) and 52.94%(9/17),with a significant difference(P<0.05) compared with serum PCT.Conclusion As an early neonatal infection marker,serum PCT is superior to CRP and WBC count and classification.Dynamic monitoring the PCT level can be used to early diagnose and effectively treat neonatal infection,also it can be used to judge whether the infection is controlled.

参考文献:

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