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目的评价前降钙素(procalcitonin,PCT)对新生儿重症细菌感染的诊断价值。方法应用免疫发光法对30例重症感染新生儿和30例非感染对照组病人在入院时进行血清PCT的定量检测,并与C反应蛋白(CRP)和白细胞计数(WBC)进行比较。同时检测其敏感度、特异性、预计值和ROC曲线下面积(AUC)。结果重症细菌感染病人在入院时血PCT质量浓度明显增高(中位数7.82μg/L,范围0.97~256.81μg/L),而非感染对照组为0.16μg/L(0.10~1.49μg/L)。PCT、CRP和WBC的ROC曲线下面积分别为0.99、0.62和0.60。预计重症感染的最佳截断值为:PCT>2μg/L(敏感度87%、特异性和阳性预计值100%、阴性预计值88%);CRP>20 mg/L、PCT>0.9μg/L时,敏感度和阴性预计值为100%,可以确诊所有重症细菌感染病人。结论重症感染新生儿入院时的PCT血质量浓度是优于CRP和WBC的细菌感染诊断指标。
Objective To evaluate the diagnostic value of procalcitonin (PCT) in neonatal severe bacterial infections. Methods Thirty patients with severe infection and 30 non-infected controls were enrolled in the study. Serum PCT levels were quantified at admission and compared with C-reactive protein (CRP) and white blood cell count (WBC). Sensitivity, specificity, predicted value, and area under the ROC curve (AUC) were also determined. Results Serum PCT concentration was significantly increased (median 7.82μg / L, range 0.97 ~ 256.81μg / L) in patients with severe bacterial infection compared with 0.16μg / L (0.10-1.49μg / L) in non-infected control group . The areas under the ROC curve for PCT, CRP and WBC were 0.99, 0.62 and 0.60, respectively. The optimal cut-off for severe infections was estimated to be PCT> 2 μg / L (sensitivity 87%, specificity and positive predictive value 100%, negative predictive value 88%), CRP> 20 mg / L, PCT> 0.9 μg / L When the sensitivity and negative predictive value of 100%, you can diagnose all patients with severe bacterial infections. Conclusions The PCT blood concentration of newborns with severe infection at admission is better than CRP and WBC in the diagnosis of bacterial infection.