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目的探讨血清降钙素原(procalationin,PCT)在新生儿细菌性血流感染中的诊断价值。方法采用回顾性分析,将2011年6月-2013年3月本院和衢州市人民医院收治的512例新生儿分为新生儿败血症组、败血症高危因素组、非败血症高危因素组,随机抽取16例同期住院健康新生儿作为对照组。比较血培养结果与血清PCT浓度的关系及PCT浓度水平在革兰氏阴性细菌、革兰氏阳性细菌之间的差异。结果败血症组PCT水平明显增高有统计学意义(P<0.05),PCT和血培养的阳性率分别为76.5%和39.2%。以血培养检测结果作为对照,PCT的敏感性为85.7%,特异性为77.3%,阳性预测值和阴性预测值分别为41.3%、96.7%。PCT在革兰阴性细菌、革兰阳性细菌中的阳性率分别为95.5%和75.0%。结论检测PCT水平有助于临床对新生儿败血症的快速排除和诊断血流感染有一定的帮助。
Objective To investigate the diagnostic value of serum procalationin (PCT) in neonatal bacterial bloodstream infection. Methods A retrospective analysis was conducted to divide 512 newborns admitted to our hospital and Quzhou People’s Hospital from June 2011 to March 2013 into neonatal sepsis group, high risk group for sepsis and high risk group for non-sepsis. Cases of hospitalized healthy newborns at the same period as a control group. Compare the relationship between blood culture results and serum PCT concentration and the difference of PCT concentration levels between Gram-negative bacteria and Gram-positive bacteria. Results The PCT levels in sepsis group were significantly increased (P <0.05). The positive rates of PCT and blood culture were 76.5% and 39.2% respectively. The results of blood culture as a control, PCT sensitivity was 85.7%, specificity was 77.3%, positive predictive value and negative predictive value were 41.3%, 96.7%. The positive rates of PCT in Gram-negative bacteria and Gram-positive bacteria were 95.5% and 75.0% respectively. Conclusion The detection of PCT levels is helpful to the clinical treatment of neonatal sepsis and to diagnose the bloodstream infection.