血清PCT、IL-6和hs-CRP早期诊断新生儿肺炎的临床价值研究
|
摘要
目的探讨血清降钙素原(PCT)、白介素-6(IL-6)和超敏C-反应蛋白(hs-CRP)早期诊断新生儿肺炎的临床价值。方法选取2016年5月—2018年5月我院收治的110例新生儿肺炎患儿(观察组)和同期于我院正常分娩的60例足月健康新生儿(对照组)作为研究对象,分析二组新生儿的临床资料,所有新生儿均行血清PCT、IL-6和hs-CRP等相关临床指标的检测与检查,记录所有新生儿性别、出生日龄等一般临床资料并比较不同新生儿上述临床资料及指标水平的差异,分析不同临床指标对新生儿肺炎的早期诊断价值。结果 (1)根据病原学检查结果可知,110例新生儿肺炎患儿中有62例为细菌性感染,占56.36%;(2)新生儿肺炎两组患儿血清PCT、IL-6和hs-CRP水平均显著高于正常新生儿,而细菌性感染新生儿肺炎患儿其血清PCT、IL-6和hs-CRP水平均明显高于非细菌性感染新生儿肺炎患儿(P<0.05);(3)细菌性感染新生儿肺炎患儿治疗后血清PCT、IL-6和hs-CRP水平均较治疗前显著下降(P<0.05),但治疗后的血清PCT、IL-6和hs-CRP水平与对照组新生儿比较均无差异(P>0.05);(4)细菌性感染新生儿肺炎患儿其血清PCT、IL-6和hs-CRP阳性率均显著高于非细菌性感染新生儿肺炎患儿(P<0.05);(5)经Spearman等级相关分析得,血清PCT、IL-6与hs-CRP以及IL-6与hs-CRP均呈正相关(P<0.05);(6)血清PCT早期诊断新生儿肺炎的灵敏度和特异性均较IL-6和hs-CRP诊断高,且当血清PCT>1.0μg/L时较高,但血清PCT、IL-6和hs-CRP联合检测早期诊断新生儿肺炎灵敏度和特异性均更佳,分别为93.8%和90.6%,差异均有统计学意义(P<0.05)。结论血清PCT、IL-6和hs-CRP在新生儿肺炎患儿中均以较高水平表达,其中PCT早期诊断新生儿肺炎较IL-6和hs-CRP好,但PCT、IL-6和hs-CRP联合检测早期诊断新生儿肺炎具有更高的灵敏度和特异性,值得作为临床上早期诊断新生儿肺炎的首选检查方案之一。
Objective To investigate the clinical value of serum procalcitonin(PCT),interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)in the early diagnosis of neonatal pneumonia.Methods From May 2016 to May 2018,one hundred and ten cases with neonatal pneumonia(observation group)and sixty full-term healthy newborns delivered in our hospital during the same period(control group)were selected.The clinical data of all neonates were retrospectively analyzed.All neonates were tested for PCT,IL-6 and hs-CRP.The general clinical data of all neonates,such as sex and age of birth,were recorded.The differences of the above clinical data and index levels among different neonates were compared,and the early diagnostic value of different clinical indicators for neonatal pneumonia was analyzed.Results(1)According to the results of etiological examination,62 of 110 neonatal pneumonia cases were bacterial infection,accounting for 56.36%;(2)The levels of PCT,IL-6 and hs-CRP in serum of the neonatal pneumonia group were significantly higher than those of normal neonates,while the levels of PCT,IL-6 and hs-CRP in serum of the bacterial pneumonia group were significantly higher than those of non-bacterial pneumonia group.(3)The levels of serum PCT,IL-6 and hs-CRP in children with bacterial pneumonia after treatment were significantly lower than those before treatment(P<0.05),but the levels of serum PCT,IL-6 and hs-CRP in children with bacterial pneumonia after treatment were not significantly different from those in control group(P>0.05);(4)The positive rates of serum PCT,IL-6 and hs-CRP in children with bacterial pneumonia were significantly higher than those in nonbacterial pneumonia.(5)Spearman grade correlation analysis showed that serum PCT,IL-6,hs-CRP and IL-6 were positively correlated with hs-CRP(P<0.05);(6)The sensitivity and specificity of serum PCT in early diagnosis of neonatal pneumonia were higher than those of IL-6 and hs-CRP,and were higher when serum PCT>1.0μg/L,but the sensitivity and specificity of combined detection of serum PCT,IL-6 and hs-CRP in early diagnosis of neonatal pneumonia were better,93.8% and 90.6%,respectively,with statistically significant differences(P<0.05).Conclusion Serum PCT,IL-6,and hs-CRP are all highly expressed in neonates with pneumonia.For single detection,the clinical value of PCT is better than that of IL-6 and hs-CRP,while the combined detection of PCT,IL-6 and hs-CRP has a higher sensitivity and specificity in early diagnosis of neonatal pneumonia,which is worthy of recommendation.
Objective To investigate the clinical value of serum procalcitonin(PCT),interleukin-6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)in the early diagnosis of neonatal pneumonia.Methods From May 2016 to May 2018,one hundred and ten cases with neonatal pneumonia(observation group)and sixty full-term healthy newborns delivered in our hospital during the same period(control group)were selected.The clinical data of all neonates were retrospectively analyzed.All neonates were tested for PCT,IL-6 and hs-CRP.The general clinical data of all neonates,such as sex and age of birth,were recorded.The differences of the above clinical data and index levels among different neonates were compared,and the early diagnostic value of different clinical indicators for neonatal pneumonia was analyzed.Results(1)According to the results of etiological examination,62 of 110 neonatal pneumonia cases were bacterial infection,accounting for 56.36%;(2)The levels of PCT,IL-6 and hs-CRP in serum of the neonatal pneumonia group were significantly higher than those of normal neonates,while the levels of PCT,IL-6 and hs-CRP in serum of the bacterial pneumonia group were significantly higher than those of non-bacterial pneumonia group.(3)The levels of serum PCT,IL-6 and hs-CRP in children with bacterial pneumonia after treatment were significantly lower than those before treatment(P<0.05),but the levels of serum PCT,IL-6 and hs-CRP in children with bacterial pneumonia after treatment were not significantly different from those in control group(P>0.05);(4)The positive rates of serum PCT,IL-6 and hs-CRP in children with bacterial pneumonia were significantly higher than those in nonbacterial pneumonia.(5)Spearman grade correlation analysis showed that serum PCT,IL-6,hs-CRP and IL-6 were positively correlated with hs-CRP(P<0.05);(6)The sensitivity and specificity of serum PCT in early diagnosis of neonatal pneumonia were higher than those of IL-6 and hs-CRP,and were higher when serum PCT>1.0μg/L,but the sensitivity and specificity of combined detection of serum PCT,IL-6 and hs-CRP in early diagnosis of neonatal pneumonia were better,93.8% and 90.6%,respectively,with statistically significant differences(P<0.05).Conclusion Serum PCT,IL-6,and hs-CRP are all highly expressed in neonates with pneumonia.For single detection,the clinical value of PCT is better than that of IL-6 and hs-CRP,while the combined detection of PCT,IL-6 and hs-CRP has a higher sensitivity and specificity in early diagnosis of neonatal pneumonia,which is worthy of recommendation.
引文
[1]Plesko M,Suvada J,Makohusova M,et al.The role of CRP,PCT,IL-6 and presepsin in early diagnosis of bacterial infectious complications in paediatric haemato-oncological patients[J].Neoplasma,2016,63(5):752
[2]贾凯.血清IL-6与PCT在新生儿肺炎早期诊断中的检测意义[J].中国医药导刊,2017,19(6):364-366
[3]黄丽娇,庄晖,刘丽明.联合检测PCT、IL-6和CRP水平在预测未足月胎膜早破患者并发绒毛膜羊膜炎及新生儿败血症的临床价值研究[J].中国妇幼保健,2016,31(17):3471-3474
[4]郑立伟.血清降钙素原联合超敏C反应蛋白检测在新生儿肺炎合并脓毒症中的临床应用[J].儿科药学杂志,2017,23(3):8-11
[5]周维军.血清降钙素原与超敏C反应蛋白检测新生儿细菌感染性肺炎的临床价值[J].临床检验杂志(电子版),2017,34(4):745-747
[6]朱琼,陈小利,叶华.降钙素原和C反应蛋白在新生儿肺炎诊治中的应用价值[J].实用心脑肺血管病杂志,2016,23(5):133-134
[7]李婕.沐舒坦不同用药途径对新生儿肺炎的白细胞、降钙素原及超敏C反应蛋白的影响分析[J].基因组学与应用生物学,2016,35(5):1081-1087
[8]代光华,李丹丹.高流量鼻导管氧疗联合维生素营养补充剂对新生儿肺炎合并呼吸衰竭的效果观察[J].解放军医药杂志,2016,28(10):61-64
[9]刘烨鼎,廖衣华,陈青微.超声心动图评估新生儿肺炎肺动脉压的临床研究[J].中国妇幼保健,2017,32(23):6053-6055
[10]赵立明,高健东,张立荣,等.心肌酶谱联合C-反应蛋白用于新生儿肺炎病情评估中的意义研究[J].河北医药,2018,46(4):476-478
[11]代如民,陈爽,张彦博.β2-微球蛋白在新生儿肺炎肾损伤中的诊断意义[J].实用预防医学,2017,24(4):489-491
[12]Liu S,Hou Y,Cui H.Clinical values of the early detection of serum procalcitonin,C-reactive protein and white blood cells for neonates with infectious diseases[J].Pakistan Journal of Medical Sciences,2016,32(6):1326
[13]邹敏书,宋秋菊,徐洪涛,等.421例住院新生儿血清25羟维生素D水平的临床观察[J].医学研究杂志,2017,46(10):40-43
[14]蔡忠忠,沈晓霞.新生儿肺炎患儿血小板参数、炎症因子及心肌酶谱水平的变化及意义[J].中国卫生检验杂志,2017,26(3):371-373
[15]李晶,何海兰,朱小石.血清降钙素原与C反应蛋白对新生儿细菌感染性肺炎的诊断价值[J].西部医学,2014,26(5):649-650
[16]尹绪凤,雷勋明.丙种球蛋白对新生儿肺炎血清相关免疫指标的影响[J].中国医师进修杂志,2017,40(3):196-199
[17]郭焕利,周熙惠.一氧化碳(CO)吸入疗法在足月新生儿肺炎中应用的安全性以及抗炎、抗氧化作用[J].临床肺科杂志,2016,21(9):1632-1634
[18]刘芳,张利兵.新生儿晚发急性胃穿孔一例误诊讨论[J].临床误诊误治,2017,30(12):18-19
[19]何瑞堂,吴雪,杨越,等.NICU新生儿肺炎克雷伯菌感染的耐药分析[J].中国实验诊断学,2017,20(12):484-486
[20]黄雅婷,李丽丽,李梅,等.肝功能异常病理性黄疸新生儿甲功水平的研究[J].保健医学研究与实践,2016,13(4):65-66
[21]林艳,李微,黄颖璇,等.血清PCT与hs-CRP对新生儿细菌感染性肺炎的诊断价值[J].海南医学,2017,28(10):1627-1628
[22]王敬敏,刘冬梅,徐琳,等.血浆NT-proBNP及H-FABP联合检测在小儿重症肺炎合并心力衰竭中的应用价值[J].解放军医药杂志,2017,29(9):106-109
[23]刘冲,云惠聪.1127例住院新生儿疾病谱分析[J].中国病案,2016,17(9):84-87
[24]Zou S,Zhang L,Chen Q,et al.The prognostic value of serum PCT,hs-CRP,and IL-6 in patients with sepsis[J].Open Life Sciences,2017,12(1):302-304
[25]金梅,陈琳,徐若梅,等.床旁肺超声诊断新生儿感染性肺炎的临床价值[J].西部医学,2015,27(4):565-567
[26]周维军.血清降钙素原与超敏C反应蛋白检测新生儿细菌感染性肺炎的临床价值[J].临床检验杂志(电子版),2017,34(4):745-747
[27]何艺.新生儿肺泡表面活性物质蛋白A基因多态性与肺炎易感性、炎症反应程度的相关性[J].海南医学院学报,2017,23(12):1668-1671
[2]贾凯.血清IL-6与PCT在新生儿肺炎早期诊断中的检测意义[J].中国医药导刊,2017,19(6):364-366
[3]黄丽娇,庄晖,刘丽明.联合检测PCT、IL-6和CRP水平在预测未足月胎膜早破患者并发绒毛膜羊膜炎及新生儿败血症的临床价值研究[J].中国妇幼保健,2016,31(17):3471-3474
[4]郑立伟.血清降钙素原联合超敏C反应蛋白检测在新生儿肺炎合并脓毒症中的临床应用[J].儿科药学杂志,2017,23(3):8-11
[5]周维军.血清降钙素原与超敏C反应蛋白检测新生儿细菌感染性肺炎的临床价值[J].临床检验杂志(电子版),2017,34(4):745-747
[6]朱琼,陈小利,叶华.降钙素原和C反应蛋白在新生儿肺炎诊治中的应用价值[J].实用心脑肺血管病杂志,2016,23(5):133-134
[7]李婕.沐舒坦不同用药途径对新生儿肺炎的白细胞、降钙素原及超敏C反应蛋白的影响分析[J].基因组学与应用生物学,2016,35(5):1081-1087
[8]代光华,李丹丹.高流量鼻导管氧疗联合维生素营养补充剂对新生儿肺炎合并呼吸衰竭的效果观察[J].解放军医药杂志,2016,28(10):61-64
[9]刘烨鼎,廖衣华,陈青微.超声心动图评估新生儿肺炎肺动脉压的临床研究[J].中国妇幼保健,2017,32(23):6053-6055
[10]赵立明,高健东,张立荣,等.心肌酶谱联合C-反应蛋白用于新生儿肺炎病情评估中的意义研究[J].河北医药,2018,46(4):476-478
[11]代如民,陈爽,张彦博.β2-微球蛋白在新生儿肺炎肾损伤中的诊断意义[J].实用预防医学,2017,24(4):489-491
[12]Liu S,Hou Y,Cui H.Clinical values of the early detection of serum procalcitonin,C-reactive protein and white blood cells for neonates with infectious diseases[J].Pakistan Journal of Medical Sciences,2016,32(6):1326
[13]邹敏书,宋秋菊,徐洪涛,等.421例住院新生儿血清25羟维生素D水平的临床观察[J].医学研究杂志,2017,46(10):40-43
[14]蔡忠忠,沈晓霞.新生儿肺炎患儿血小板参数、炎症因子及心肌酶谱水平的变化及意义[J].中国卫生检验杂志,2017,26(3):371-373
[15]李晶,何海兰,朱小石.血清降钙素原与C反应蛋白对新生儿细菌感染性肺炎的诊断价值[J].西部医学,2014,26(5):649-650
[16]尹绪凤,雷勋明.丙种球蛋白对新生儿肺炎血清相关免疫指标的影响[J].中国医师进修杂志,2017,40(3):196-199
[17]郭焕利,周熙惠.一氧化碳(CO)吸入疗法在足月新生儿肺炎中应用的安全性以及抗炎、抗氧化作用[J].临床肺科杂志,2016,21(9):1632-1634
[18]刘芳,张利兵.新生儿晚发急性胃穿孔一例误诊讨论[J].临床误诊误治,2017,30(12):18-19
[19]何瑞堂,吴雪,杨越,等.NICU新生儿肺炎克雷伯菌感染的耐药分析[J].中国实验诊断学,2017,20(12):484-486
[20]黄雅婷,李丽丽,李梅,等.肝功能异常病理性黄疸新生儿甲功水平的研究[J].保健医学研究与实践,2016,13(4):65-66
[21]林艳,李微,黄颖璇,等.血清PCT与hs-CRP对新生儿细菌感染性肺炎的诊断价值[J].海南医学,2017,28(10):1627-1628
[22]王敬敏,刘冬梅,徐琳,等.血浆NT-proBNP及H-FABP联合检测在小儿重症肺炎合并心力衰竭中的应用价值[J].解放军医药杂志,2017,29(9):106-109
[23]刘冲,云惠聪.1127例住院新生儿疾病谱分析[J].中国病案,2016,17(9):84-87
[24]Zou S,Zhang L,Chen Q,et al.The prognostic value of serum PCT,hs-CRP,and IL-6 in patients with sepsis[J].Open Life Sciences,2017,12(1):302-304
[25]金梅,陈琳,徐若梅,等.床旁肺超声诊断新生儿感染性肺炎的临床价值[J].西部医学,2015,27(4):565-567
[26]周维军.血清降钙素原与超敏C反应蛋白检测新生儿细菌感染性肺炎的临床价值[J].临床检验杂志(电子版),2017,34(4):745-747
[27]何艺.新生儿肺泡表面活性物质蛋白A基因多态性与肺炎易感性、炎症反应程度的相关性[J].海南医学院学报,2017,23(12):1668-1671