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目的 :探讨降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)联合检测对于各类新生儿感染性疾病的临床诊断价值。方法:选取我院同时进行PCT和CRP检测的新生儿,其中血流感染24例,肺炎27例(肺炎组),并选取排除血流感染和肺部感染的健康新生儿28例作为正常对照组。检测感染性疾病患儿和健康新生儿的PCT和CRP水平。通过诊断试验四格表分别计算灵敏度、特异度、阳性预测值和阴性预测值。结果:正常对照组的PCT和CRP水平分别为(0.48±0.01)ng/m L、(1.17±0.09)mg/L,血流感染组分别为(1.51±0.57)ng/m L、(8.98±2.64)mg/L,肺炎组分别为(0.87±0.27)ng/m L、(6.67±1.67)mg/L。后两组的PCT、CRP水平均明显高于正常对照组的检测结果,差异有统计学意义(P<0.05)。在血流感染和肺部感染时,单独检测PCT、CRP及两者联合检测的特异度均为82.1%、92.9%和96.4%。结论 :PCT和CRP检测对于新生儿感染有重要的临床诊断价值,尤其在血流感染和肺部感染时,联合检测PCT和CRP的特异度较高,检测低值能快捷、有效地排除新生儿感染。
Objective: To investigate the clinical value of combined detection of procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis of neonatal infectious diseases. Methods: Neonates with simultaneous detection of PCT and CRP in our hospital were selected, of which 24 were bloodstream infection and 27 were pneumonia (pneumonia group). Twenty-eight healthy newborns with bloodstream infection and pulmonary infection were excluded as normal control group . PCT and CRP levels were measured in children with infectious diseases and healthy newborns. The sensitivity, specificity, positive predictive value and negative predictive value were calculated respectively by four tables of diagnostic tests. Results: The levels of PCT and CRP in the normal control group were (0.48 ± 0.01) ng / m L and (1.17 ± 0.09) mg / L respectively, and those in the bloodstream infection group were (1.51 ± 0.57) ng / m L and 2.64) mg / L and pneumonia group were (0.87 ± 0.27) ng / m L and (6.67 ± 1.67) mg / L, respectively. The PCT and CRP levels of the latter two groups were significantly higher than those of the normal control group (P <0.05). In the case of bloodstream infection and pulmonary infection, the specificity of the combined detection of PCT, CRP alone and both were 82.1%, 92.9% and 96.4% respectively. Conclusions: The PCT and CRP tests have important clinical diagnostic value for neonatal infection. Especially in the case of bloodstream infection and pulmonary infection, the combined detection of PCT and CRP has a high specificity, and the detection of low values can be quickly and effectively ruled out neonates infection.