摘要
目的探讨presepsin在新生儿迟发型脓毒症(LOS)早期诊断中的临床价值。方法选取2017年8月—2018年5月入住龙岩市第一医院新生儿科LOS患儿46例和同期无感染性疾病新生儿36例。采用化学发光酶免疫法检测两组血液presepsin水平,探讨presepsin与降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)在新生儿LOS中的诊断效能。结果 LOS组presepsin、PCT、WBC水平均显著高于对照组(P <0.001),而两组间CRP则无差异(P>0.05),且presepsin与PCT、CRP、WBC间均未见相关性(P>0.05)。LOS组presepsin和PCT的曲线下面积(ROCAUC)分别为0.925和0.986,敏感性分别为78.26%和93.48%,特异性均为97.22%。Presepsin联合PCT的ROCAUC最大,为0.989,且敏感性(95.65%)、特异性(100.00%)均明显高于单独presepsin或PCT指标。结论 Presepsin是评价新生儿LOS的特异指标,联合PCT检测提高了对其新生儿LOS的诊断价值,优于单独presepsin或PCT指标。
Objective To investigate the clinical value of presepsin in early diagnosis of neonatal late-onset sepsis(LOS). Methods A total of 46 newborns with LOS admitted to the Neonatal Department of Longyan First Hospital from August 2017 to May 2018 and 36 cases of neonates without infectious diseases in the same period were selected.The blood presepsin levels in the two groups were determined by chemilumin-escence enzyme immunoassay,and the diagnostic efficiency of presepsin,procalcitonin(PCT),C-reactive protein(CRP)and white blood cell(WBC)for neonatal LOS were investigated. Results The levels of presepsin,PCT and WBC in the LOS group were significantly higher than those in the control group(P <0.001),while the CRP between the two groups showed no difference(P >0.05),and there presepsin had no correlation with PCT,CRP and WBC(P >0.05).The area under the receiver-operating characteristic curve(ROCAUC)of resepsin and PCT in LOS group was 0.925 and 0.986,respectively,and the sensitivity was 78.26%and 93.48%,respectively,and the specificity of both presepsin and PCT was 97.22%.The ROCAUC of presepsin combined with PCT was 0.989 which was the largest,and the sensitivity(95.65%)and specificity(100.00%)were significantly higher than those of presepsin or PCT alone. Conclusion Presepsin is a specific indicator to evaluate neonatal LOS.Presepsin combined with PCT detection improves their diagnosis value of neonatal LOS,which is better than the single detection of presepsin or PCT.
引文
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