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目的:探讨血清白蛋白(ALB)水平对新生儿败血症患儿预后的影响。方法:将92例新生儿败血症患儿根据预后情况分为存活组(62例)和死亡组(30例)。在确诊为新生儿败血症时及确诊后的第1、3、5、7天检测两组血清ALB。于确诊为新生儿败血症时比较两组血清降钙素原(PCT)水平、超敏C反应蛋白(hs-CRP)水平、白细胞(WBC)计数、血小板(PLT)计数和新生儿危重病例评分(NCIS);应用Pearson相关性分析血清ALB水平与PCT水平、hs-CRP水平、WBC计数、PLT计数和NCIS的相关性。新生儿败血症确诊时绘制92例患儿血清ALB水平的受试者工作特征(ROC)曲线,分析其对死亡的预测效果。结果:死亡组血清ALB在确诊新生儿败血症时及确诊后的第1、3、5、7天一直维持较低水平,存活组血清ALB上升,且死亡组均低于存活组(P<0.05);确诊为新生儿败血症时,死亡组血清PCT水平、hs-CRP水平和WBC计数高于存活组,PLT计数和NCIS低于对照组(P<0.05);经过Pearson相关分析,血清ALB水平与PCT水平、hs-CRP水平和WBC计数呈负相关,与PLT计数、NCIS呈正相关(P<0.05);92例新生儿败血症患儿血清ALB水平对死亡预测的ROC曲线下总面积为0.878,21.17 g/L为血清ALB的最佳阈值,灵敏度为87.63%,特异性为100%。结论:血清ALB水平可作为新生儿败血症预后判断指标,为后期临床治疗提供依据。
Objective: To investigate the effect of serum albumin (ALB) on the prognosis of neonatal sepsis. Methods: 92 cases of neonatal sepsis were divided into survival group (62 cases) and death group (30 cases) according to the prognosis. Two groups of serum ALB were detected on the 1st, 3rd, 5th and 7th days after the diagnosis of neonatal sepsis. The levels of serum procalcitonin (PCT), hs-CRP, WBC, PLT and neonatal critically ill patients were compared at the time of diagnosis of neonatal sepsis NCIS). Pearson correlation was used to analyze the correlation between serum ALB level and PCT level, hs-CRP level, WBC count, PLT count and NCIS. During the diagnosis of neonatal sepsis, 92 patients with serum albumin (ALB) levels were plotted on a ROC curve to analyze the predictive value of death. Results: Serum ALB in the death group remained at a low level on the 1st, 3rd, 5th and 7th days after the diagnosis of neonatal sepsis and the serum ALB level in the surviving group was lower than that in the surviving group (P <0.05) ; When diagnosed as neonatal sepsis, serum PCT levels, hs-CRP levels and WBC counts in death group were higher than those in survival group, PLT counts and NCIS were lower than those in control group (P <0.05); After Pearson correlation analysis, The level of hs-CRP was negatively correlated with WBC count, positively correlated with PLT count and NCIS (P <0.05). The total area under the ROC curve of serum ALB level in 92 neonates with septicemia was 0.878 and 21.17 g / L is the optimal threshold for serum ALB with a sensitivity of 87.63% and a specificity of 100%. Conclusion: Serum ALB level can be used as a prognostic indicator of neonatal sepsis and provide the basis for clinical treatment.