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目的探讨新生儿脓毒症患儿血清C-反应蛋白(CRP)和脑钠肽(BNP)浓度变化与疾病进展的关系。方法选择陈星海医院2012年1月-2013年12月入院的诊断为新生儿脓毒症的患儿56例为病例组,分为A组(心肌损伤组)(22例)和B组(非心肌损伤组)(34例)。另选取23例无感染、先天性心脏病及窒息的高胆红素血症新生儿作为C组(对照组)参与本研究,在治疗前及治疗后7~10 d检测血清BNP、CRP和肌酸激酶同功酶(CK-MB)水平。结果病例组血清BNP、CK-MB和CRP水平显著升高,差异具有统计学意义(P<0.05)。A组和B组治疗前血清BNP水平比较差异具有统计学意义(P<0.05),血清CRP和CK-MB水平比较差异无统计学意义(P>0.05);治疗后血清BNP、CK-MB和CRP水平随着病情的恢复逐渐下降,差异无统计学意义(P>0.05)。结论新生儿脓毒症急性期血清CRP和BNP水平可作为新生儿脓毒症判断病情的良好辅助指标,同时血清BNP水平也可早期诊断新生儿脓毒症心肌损伤,为新生儿脓毒症心肌损伤提供早期诊断的可靠实验室指标。
Objective To investigate the relationship between serum C-reactive protein (CRP) and brain natriuretic peptide (BNP) levels in neonates with sepsis and the disease progression. Methods Fifty-six children diagnosed as neonatal sepsis admitted from January 2012 to December 2013 in Chen Xinghai Hospital were divided into group A (myocardial injury group) (22 cases) and group B Myocardial injury group) (34 cases). Another 23 neonates with non-infection, congenital heart disease and asphyxia with hyperbilirubinemia were selected as the control group. The serum levels of BNP, CRP and muscle were measured before treatment and 7-10 days after treatment Acid kinase isoenzyme (CK-MB) levels. Results Serum levels of BNP, CK-MB and CRP were significantly increased in the case group, the difference was statistically significant (P <0.05). The levels of BNP in serum before treatment in group A and group B were significantly different (P <0.05), and there was no significant difference in serum CRP and CK-MB between group A and group B (P> 0.05) CRP level gradually decreased with the recovery of the disease, the difference was not statistically significant (P> 0.05). Conclusions Serum levels of CRP and BNP in acute sepsis can be used as a good adjunct to determine neonatal sepsis. Serum BNP levels can also be used to diagnose myocardial injury in neonates with sepsis in early stage, Damage provides reliable laboratory indicators of early diagnosis.