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目的探讨降钙素原(PCT)、白细胞介素-6(IL-6)及C反应蛋白(CRP)对新生儿宫内细菌感染的诊断价值。方法选取2010—2011年在我院产科分娩、有宫内感染高危因素的新生儿,根据感染结局分为感染组及无感染组,检测两组新生儿脐血PCT、IL-6及CRP,比较两组新生儿脐血炎症指标的阳性率及各指标对宫内感染诊断的敏感度和特异度。结果共有195例新生儿纳入研究,其中感染组24例,无感染组171例。感染组脐血PCT与IL-6的阳性率均明显高于CRP,诊断细菌感染的敏感度及特异度分别为:PCT敏感度70.8%,特异度94.2%;IL-6敏感度79.2%,特异度89.5%;CRP敏感度33.3%,特异度96.5%。PCT与IL-6结合诊断感染的敏感度为95.8%。结论脐血PCT可作为宫内细菌感染早期诊断的有效指标,而PCT与IL-6结合可进一步提高诊断的敏感度,指导临床抗生素使用。
Objective To investigate the diagnostic value of procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) in neonatal intrauterine bacterial infection. Methods The neonates with obstetric delivery and high risk of intrauterine infection in our hospital from 2010 to 2011 were selected and divided into infection group and non-infection group according to the infection outcome. The levels of PCT, IL-6 and CRP in neonates were detected. The positive rate of neonatal cord blood inflammation index and the sensitivity and specificity of each index in the diagnosis of intrauterine infection. Results A total of 195 newborns were included in the study, of which 24 were infected and 171 were noninfected. The positive rates of PCT and IL-6 in cord blood of infected group were significantly higher than that of CRP. The sensitivity and specificity of PCT were 70.8% for PCT, 94.2% for PCT, 79.2% for IL-6, Degrees 89.5%; CRP sensitivity 33.3%, specificity 96.5%. PCT combined with IL-6 in the diagnosis of infection sensitivity was 95.8%. Conclusion Umbilical cord blood PCT can be used as an effective indicator for the early diagnosis of intrauterine bacterial infection. PCT combined with IL-6 can further improve the diagnostic sensitivity and guide clinical antibiotic use.