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目的探讨重症新生儿B群链球菌感染者降钙素原(PCT)和D二聚体(D-D)检测价值及危险因素。方法选取2011年6月-2016年10月洛阳北方企业集团有限公司职工医院监护病房(NICU)收治的细菌培养B群链球菌阳性新生儿52例。确诊后12 h内无菌采集静脉血,免疫发光法检测外周血PCT,免疫比浊法检测D-D水平,记录可能引发B群链球菌感染的影响因素。结果分娩方式、胎膜早破、出生体质量和产前B群链球菌筛查均与新生儿B群链球菌感染相关(P<0.05),其中顺产、胎膜早破时间超过12 h、出生体质量<2 500 g、产前未筛查B群链球菌是新生儿B群链球菌感染的易感因素。重症肺炎合并休克患儿PCT阳性率和D-D水平明显高于重症肺炎患儿,差异有统计学意义(P<0.05);败血症合并脑膜炎患儿PCT阳性率和D-D水平明显高于重症肺炎患儿,差异有统计学意义(P<0.05)。结论检测PCT和D-D水平对重症新生儿B群链球菌感染的病情评估和治疗有重要价值;控制感染危险因素可降低新生儿B群链球菌感染的发生率。
Objective To investigate the value and risk factors of procalcitonin (PCT) and D-dimer (D-D) in severe neonates with group B streptococcal infection. Methods Fifty-two newborns positive for group B streptococcus were admitted to NICU from June 2011 to October 2016 in Luoyang Northern Enterprise Group Co., Ltd. Intravenous blood was collected aseptically within 12 hours after diagnosis, peripheral blood PCT was detected by immunoluminescence assay, D-D level was measured by immunoturbidimetry, and the influencing factors of group B streptococcal infection were recorded. Results Mode of delivery, premature rupture of membranes, birth weight and prenatal group B streptococcal screening were associated with neonatal group B streptococcal infection (P <0.05), of which the time of birth, premature rupture of membranes was more than 12 h Body mass <2 500 g, prenatal screening group B streptococcus is a susceptible factor of Neisseria group B streptococcal infection. The positive rates of PCT and DD in children with severe pneumonia complicated with shock were significantly higher than those in severe pneumonia (P <0.05). The positive rates of PCT and DD in children with severe pneumonia complicated with meningitis were significantly higher than those in children with severe pneumonia , The difference was statistically significant (P <0.05). Conclusion The detection of PCT and D-D levels has important value in the assessment and treatment of severe Neonatal Group B streptococcal infections. Controlling the risk factors of infection can reduce the incidence of Neisseria group B streptococcal infection.