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目的:探讨动态监测血清降钙素原(PCT)在新生儿细菌感染性疾病治疗中的价值,为临床有效诊治提供参考依据。方法:以112例细菌感染性疾病新生儿为研究对象,将其分为局部细菌感染组(70例)和重症细菌感染组(42例),同时选取健康新生儿为对照组(34例),比较3组新生儿PCT、C反应蛋白(CRP)、白细胞(WBC)计数差异和PCT、CRP、WBC计数的阳性率,动态监测治疗过程中PCT、CRP、WBC计数的变化。结果:重症细菌感染组患儿PCT、CRP及WBC计数分别为(12.54±4.69)ng·ml-1、(41.87±7.78)mg·L~(-1)、(26.21±5.91)×109L~(-1),均明显高于对照组和局部细菌感染组(P<0.05);PCT检测阳性率为91.07%,明显高于CRP检测(χ2=9.931,P<0.05)和WBC计数检测法(χ2=44.667,P<0.05);细菌感染被控制后,PCT可以迅速降低到正常水平(<0.2 ng·ml~(-1)),但CRP及WBC计数降低相对缓慢。结论:血清PCT可有效判断新生儿细菌感染性疾病严重程度,动态监测PCT水平变化可观察药物疗效,值得临床推广使用。
Objective: To investigate the value of dynamic monitoring serum procalcitonin (PCT) in the treatment of neonatal bacterial infectious diseases and provide a reference for clinical diagnosis and treatment. Methods: One hundred and twelve newborns with bacterial infectious diseases were divided into two groups: local bacterial infection group (70 cases) and severe bacterial infection group (42 cases), healthy newborns were selected as control group (34 cases) The differences of PCT, C-reactive protein (CRP), leukocyte count (WBC) count and PCT, CRP and WBC counts were compared between the three groups to dynamically monitor the changes of PCT, CRP and WBC count during the treatment. Results: The counts of PCT, CRP and WBC in severe bacterial infection group were (12.54 ± 4.69) ng · ml -1, (41.87 ± 7.78) mg · L -1, (26.21 ± 5.91) × 109 L ~ (-1) (P <0.05). The positive rate of PCT test was 91.07%, which was significantly higher than that of CRP test (χ2 = 9.931, P <0.05) and WBC count test (χ2 = 44.667, P <0.05). After the bacterial infection was controlled, PCT could be rapidly reduced to normal level (<0.2 ng · ml -1), but the relative reduction of CRP and WBC count was relatively slow. Conclusion: Serum PCT can effectively determine the severity of neonatal bacterial infectious disease, dynamic monitoring of PCT level changes can be observed in the efficacy of the drug, worthy of clinical promotion and use.