降钙素原和超敏C反应蛋白在新生儿败血症早期诊断中的意义

郭利美　秦微　谭稻香　梁启慧?王煜俊?易千仞?王敏雅

[摘要] 目的 探讨在新生儿败血症早期诊断降钙素原和超敏C反应蛋白的临床意义与价值。 方法 选取我院2014年1月～2015年1月收治的新生儿败血症患儿共52例作为观察组，选择同期非新生儿败血症患儿共52例作为对照组，收集两组患儿临床资料中降钙素原与超敏C反应蛋白的水平。比较观察组与对照组患儿血清降钙素原与超敏C反应蛋白的水平。 结果 观察组新生儿败血症患儿血清中降钙素原检测阳性率为84.6%，超敏C反应蛋白检测阳性率为67.3%，明显高于对照组非新生儿败血症患儿降钙素原与超敏C反应蛋白检测阳性率，差异有统计学意义（P<0.05）。观察组患儿血清降钙素原检测灵敏度为84.6%，特异度为80.8%，均明显高于超敏C反应蛋白灵敏度与特异度，差异有统计学意义（P<0.05）。 结论 在新生儿败血症早期，患儿血清中降钙素原与超敏C反应蛋白水平有明显变化，且通过检测降钙素原与超敏C反应蛋白可以作为诊断新生儿败血症的主要依据，降钙素原检测灵敏度与特异度高于超敏C反应蛋白，联合检测二者有助于诊断新生儿败血症。

[关键词] 新生儿败血症；降钙素原；超敏C反应蛋白；检测；诊断

[中图分类号] R722.131 [文献标识码] B [文章编号] 2095-0616（2016）01-211-03

[Abstract] Objective To explore the clinical significance and value of the early diagnosis of neonatal sepsis with the calcitonin and C reactive protein. Methods A total of 52 neonatal sepsis patients were treated in our hospital from January 2014 to January 2015 and selected as the observation group，a total of 52 patients with non neonatal sepsis were selected as the control group. The levels of calcitonin and C reactive protein in the clinical data of the two groups were collected. The serum level of calcitonin and C reactive protein in the serum of the two groups were compared. Results In the observation group， the calcitonin and C reactive protein positive rate was 84.6% and 67.3% in the serum of neonatal sepsis， which was significantly higher than that of the control group， the difference was statistically significant（P<0.05）. The sensitivity and specificity of serum calcium level in the observation group were 84.6% and 80.8% respectively， which were significantly higher than that of the control group， and the difference was statistically significant（P<0.05）. Conclusion In the early stage of neonatal sepsis， the serum levels of calcitonin and C reactive protein had already obvious changed， the main basis for the diagnosis of neonatal sepsis was detected by the expression of calcitonin and C reactive protein. The sensitivity and specificity of calcitonin were higher than those of the high sensitive C reactive protein， and the combined detection of the two index was helpful for the diagnosis of neonatal sepsis.

[Key words] Neonatal sepsis； Calcitonin； C reactive protein； Detection and diagnosis

新生儿败血症是由于在患儿新生儿期时细菌侵入血液，并成长繁殖，产生细菌毒素造成新生儿全身感染的一类疾病，是造成新生儿夭折的主要原因之一[1-2]。细菌易通过血液入侵新生儿是由于新生儿肠道屏障及皮肤屏障等发育不完善[3]，加之新生儿免疫抵抗主要依靠母体血清中lgG，缺少其他免疫球蛋白，并且随着出生时间的延长，新生儿体内的lgG水平越来越低，所以导致新生儿易被细菌感染[4-5]。新生儿罹患败血症时临床症状与表现缺乏特异性，多不能引起家长的足够重视，并且临床上诊断新生儿败血症多采用血培养，但血培养时间周期长，阳性率低，造成了临床诊断新生儿败血症变得复杂与困难[6-7]。……