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目的:探讨降钙素原、IL-6及CRP对新生儿宫内细菌感染诊断的临床价值。方法:采用回顾性分析方法,对121例疑似宫内细菌感染的新生儿的相关临床资料进行比较分析。通过影像学或细菌学方法对患儿进行检查判定感染类型,并检测患儿脐血中的降钙素原、C-反应蛋白(CRP)和白细胞介素-6(IL-6)的水平。结果:在121例患儿中41例确定为细菌感染,IL-6(>100ng/L)与CRP(>10mg/L)联合对诊断新生儿宫内细菌感染的敏感性为90.1%,特异性为76.9%,阴性预测率为91.7%,阳性预测率为71.9%;与PCT结合后,诊断新生儿宫内细菌感染的敏感性升高至98.3%,特异性为67.8%,阴性预测率为99.2%,阳性预测率为57.0%。结论:脐血PCT可作为新生儿宫内细菌感染诊断的有效指标,可明显提高IL-6与CRP诊断新生儿宫内细菌感染的阴性预测值和敏感性,指导临床治疗。
Objective: To investigate the clinical value of procalcitonin, IL-6 and CRP in the diagnosis of neonatal intrauterine bacterial infection. Methods: A retrospective analysis of 121 cases of intrauterine infection of newborns related to clinical data were analyzed. Children were examined by imaging or bacteriological methods to determine the type of infection and to detect the levels of procalcitonin, C-reactive protein (CRP) and interleukin-6 (IL-6) in cord blood of children. Results: Of 121 cases, 41 cases were confirmed as bacterial infection. The sensitivity of combination of IL-6 (> 100ng / L) and CRP (> 10mg / L) to diagnose neonatal intrauterine infection was 90.1% Was 76.9%. The negative predictive value was 91.7% and the positive predictive value was 71.9%. After combined with PCT, the sensitivity of diagnosing neonatal intrauterine bacterial infection increased to 98.3%, the specificity was 67.8% and the negative predictive value was 99.2 %, The positive predictive rate was 57.0%. Conclusion: Cord blood PCT can be used as an effective indicator in the diagnosis of neonatal intrauterine bacterial infection, which can significantly improve the negative predictive value and sensitivity of IL-6 and CRP in the diagnosis of neonatal intrauterine bacterial infection and guide the clinical treatment.