新生儿体内降钙素原变化的临床意义
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摘要
目的探索新生儿体内降钙素原变化的临床意义。方法 120例新生儿为研究对象,根据新生儿感染程度分为重症感染组、局部感染组和非感染组,每组40例,对比分子三组新生儿的降钙素原、C反应蛋白、白细胞介素-6检测水平。结果重症感染组患儿的降钙素原为(34.05±12.36)ng/ml、白细胞介素-6为(178.56±24.36)ng/L、C反应蛋白为(26.31±5.36)mg/L,局部感染组患儿的降钙素原为(12.30±1.05)ng/ml、白细胞介素-6为(75.39±10.02)ng/L、C反应蛋白为(12.36±2.04)mg/L,非感染组新生儿的降钙素原为(0.32±0.41)ng/ml、白细胞介素-6为(8.36±2.04)ng/L、C反应蛋白为(7.62±2.05)mg/L。重症感染组均高于局部感染组和非感染组,局部感染组均高于非感染组,差异均具有统计学意义(P<0.05)。降钙素原在重症感染患儿中敏感性为93.75%,特异性为87.50%,漏诊率为6.25%,误诊率为12.50%。降钙素原在局部感染患儿中的敏感度为96.67%,特异度为90.00%,漏诊率为3.33%,误诊率为10.00%。结论降钙素原能够反映新生儿感染程度,持续性升高可提示预后差。
Objective To explore the clinical significance of changes of procalcitonin in newborns.Methods A total of 120 newborns as study subjects were divided by degrees of neonatal infections into severe infection group,local infection,non infection group,with 40 cases in each group.Comparison were made on procalcitonin,C-reactive protein,interleukin-6 levels in three groups.Results The severe infection group had procalcitonin as(34.05±12.36) ng/ml,interleukin-6 as(178.56±24.36)ng/L and C-reactive protein as(26.31±5.36) mg/L,local infection group had procalcitonin as(12.30±1.05) ng/ml,interleukin-6 as(75.39±10.02) ng/L and C-reactive protein as(12.36±2.04) mg/L,and non infection group had procalcitonin as(0.32±0.41) ng/ml,interleukin-6 as(8.36±2.04) ng/L and C-reactive protein as(7.62±2.05) mg/L.The severe infection group had higher indexes than local infection group and non infection group,and local infection group had higher indexes than non infection group.All their differences had statistical significance(P<0.05).Procalcitonin had sensitivity as 93.75%,specificity as 87.50%,missed diagnosis rate as 6.25%,and misdiagnosis rate as 12.50%in severe infection children.Procalcitonin had sensitivity as 96.67%,specificity as 90.00%,missed diagnosis rate as 3.33%,and misdiagnosis rate as 10.00%.Conclusion Procalcitonin can reflect the degree of neonatal infection,and continuous rise may indicate poor prognosis.
Objective To explore the clinical significance of changes of procalcitonin in newborns.Methods A total of 120 newborns as study subjects were divided by degrees of neonatal infections into severe infection group,local infection,non infection group,with 40 cases in each group.Comparison were made on procalcitonin,C-reactive protein,interleukin-6 levels in three groups.Results The severe infection group had procalcitonin as(34.05±12.36) ng/ml,interleukin-6 as(178.56±24.36)ng/L and C-reactive protein as(26.31±5.36) mg/L,local infection group had procalcitonin as(12.30±1.05) ng/ml,interleukin-6 as(75.39±10.02) ng/L and C-reactive protein as(12.36±2.04) mg/L,and non infection group had procalcitonin as(0.32±0.41) ng/ml,interleukin-6 as(8.36±2.04) ng/L and C-reactive protein as(7.62±2.05) mg/L.The severe infection group had higher indexes than local infection group and non infection group,and local infection group had higher indexes than non infection group.All their differences had statistical significance(P<0.05).Procalcitonin had sensitivity as 93.75%,specificity as 87.50%,missed diagnosis rate as 6.25%,and misdiagnosis rate as 12.50%in severe infection children.Procalcitonin had sensitivity as 96.67%,specificity as 90.00%,missed diagnosis rate as 3.33%,and misdiagnosis rate as 10.00%.Conclusion Procalcitonin can reflect the degree of neonatal infection,and continuous rise may indicate poor prognosis.
引文
[1]李绍锦,李上淼,杨娇娇,等.检测降钙素原及超敏C-反应蛋白在新生儿感染的临床意义.中华医院感染学杂志,2012,22(10):2104-2105.
[2]何依绮,傅万海,孟琼,等.降钙素原联合C反应蛋白和白细胞检测在新生儿感染性肺炎中的意义.广东医学,2014,85(11):1708-1710.
[3]金胜鑫,石海矾,李伟,等.血清降钙素原与超敏C反应蛋白及白介素6在新生儿早期感染中的诊断价值.中华医院感染学杂志,2013,23(7):1600-1601,1637.
[4]何池英.降钙素原、C反应蛋白和白细胞计数在新生儿感染性疾病诊断中的应用.实用预防医学,2012,19(10):1558-1559.
[5]葛小丽,孙海斌,陈洪敏,等.血清降钙素原对新生儿脓毒血症预后的预测价值.临床儿科杂志,2012,30(10):953-956.
[6]Zhong ML,Chen XQ,Fan HS,et al.Incorporation of salmon calcitonin-loaded poly(lactide-co-glycolide)(PLGA)microspheres into calcium phosphate bone cement and the biocompatibility evaluation in vitro.Journal of Bioactive&Compatible Polymers,2012,27(2):133-147.
[7]张成元,张春磊,张海鲲,等.感染性疾病新生儿血清降钙素原、甲状腺激素水平变化及其与胎龄的关系.山东医药,2014,75(32):54-55.
[8]赵满仓,范永谦.降钙素原和超敏C反应蛋白检测在诊断新生儿感染性疾病中的临床价值.国际检验医学杂志,2013,34(17):2326-2327.
[9]陈巧红,葛勤,陈珊珊,等.降钙素原协同C-反应蛋白和白介素-6检测对新生儿细菌感染的诊断价值.中国医药导报,2012,09(13):94-95.
[10]杨举红.联合检测窒息新生儿脐血降钙素原和D-二聚体的临床研究.国际检验医学杂志,2016,37(14):2039-2040.
[11]李贵霞,马莉,张丽霞.新生儿败血症降钙素原和C反应蛋白检测及临床意义.检验医学,2005,20(3):250-252.
[12]苏卫东,徐克,瞿尔力,等.新生儿严重感染血清降钙素原监测的临床意义.临床医学,2006,26(4):66-67.
[13]王小丽,郭亮,陈晓利,等.降钙素原在新生儿感染疾病病程中的时相变化及临床意义.当代医学,2015(10):147-148.
[14]徐昱,朱宏斌,张凤仙.早产儿血清降钙素原水平的变化及临床意义初探.中国病案,2010,11(3):27-28.
[15]王利利,席晓莹,姜朕,等.新生儿感染性疾病血小板参数、降钙素原的变化及临床意义.浙江医学,2016,38(13):1116-1118.
[2]何依绮,傅万海,孟琼,等.降钙素原联合C反应蛋白和白细胞检测在新生儿感染性肺炎中的意义.广东医学,2014,85(11):1708-1710.
[3]金胜鑫,石海矾,李伟,等.血清降钙素原与超敏C反应蛋白及白介素6在新生儿早期感染中的诊断价值.中华医院感染学杂志,2013,23(7):1600-1601,1637.
[4]何池英.降钙素原、C反应蛋白和白细胞计数在新生儿感染性疾病诊断中的应用.实用预防医学,2012,19(10):1558-1559.
[5]葛小丽,孙海斌,陈洪敏,等.血清降钙素原对新生儿脓毒血症预后的预测价值.临床儿科杂志,2012,30(10):953-956.
[6]Zhong ML,Chen XQ,Fan HS,et al.Incorporation of salmon calcitonin-loaded poly(lactide-co-glycolide)(PLGA)microspheres into calcium phosphate bone cement and the biocompatibility evaluation in vitro.Journal of Bioactive&Compatible Polymers,2012,27(2):133-147.
[7]张成元,张春磊,张海鲲,等.感染性疾病新生儿血清降钙素原、甲状腺激素水平变化及其与胎龄的关系.山东医药,2014,75(32):54-55.
[8]赵满仓,范永谦.降钙素原和超敏C反应蛋白检测在诊断新生儿感染性疾病中的临床价值.国际检验医学杂志,2013,34(17):2326-2327.
[9]陈巧红,葛勤,陈珊珊,等.降钙素原协同C-反应蛋白和白介素-6检测对新生儿细菌感染的诊断价值.中国医药导报,2012,09(13):94-95.
[10]杨举红.联合检测窒息新生儿脐血降钙素原和D-二聚体的临床研究.国际检验医学杂志,2016,37(14):2039-2040.
[11]李贵霞,马莉,张丽霞.新生儿败血症降钙素原和C反应蛋白检测及临床意义.检验医学,2005,20(3):250-252.
[12]苏卫东,徐克,瞿尔力,等.新生儿严重感染血清降钙素原监测的临床意义.临床医学,2006,26(4):66-67.
[13]王小丽,郭亮,陈晓利,等.降钙素原在新生儿感染疾病病程中的时相变化及临床意义.当代医学,2015(10):147-148.
[14]徐昱,朱宏斌,张凤仙.早产儿血清降钙素原水平的变化及临床意义初探.中国病案,2010,11(3):27-28.
[15]王利利,席晓莹,姜朕,等.新生儿感染性疾病血小板参数、降钙素原的变化及临床意义.浙江医学,2016,38(13):1116-1118.