摘要
目的评价前降钙素(procalcitonin,PCT)对新生儿重症细菌感染的诊断价值.方法应用免疫发光法对30例重症感染新生儿和30例非感染对照组病人在入院时进行血清PCT的定量检测,并与C反应蛋白(CRP)和白细胞计数(WBC)进行比较.同时检测其敏感度、特异性、预计值和ROC曲线下面积(AUC).结果重症细菌感染病人在入院时血PCT质量浓度明显增高(中位数7.82 μg/L,范围0.97～256.81 μg/L),而非感染对照组为0.16 μg/L(0.10～1.49 μg/L).PCT、CRP和WBC的ROC曲线下面积分别为0.99、0.62和0.60.预计重症感染的最佳截断值为:PCT＞2 μg/L(敏感度87%、特异性和阳性预计值100%、阴性预计值88%);CRP＞20 mg/L、PCT＞0.9 μg/L时,敏感度和阴性预计值为100%,可以确诊所有重症细菌感染病人.结论重症感染新生儿入院时的PCT血质量浓度是优于CRP和WBC的细菌感染诊断指标.
Objective Procalcitonin（PCT） has been regarded as a marker of bacterial infection. The purpose of this study was to evaluate the diagnostic value of PCT in neonates with severe bacterial infection. Methods The serum PCT concentrations were measured in quantity with immunoluminometric assay and compared with C reactive protein（CRP） and leucocyte count（WBC） in 30 critically ill neonates and 30 non-infected neonates as control. Optimum sensitivity, specificity, predictive values and area under the receiver operating characteristic（ROC） curve were evaluated. Results The serum PCT at admission was much higher in neonates with severe bacterial diseases（media 7.82μg/L;range 0. 97-256. 81 μg/L）, compared with non-infected neonates as control（0.16μg/L;0.10-1.49μg/L）. Area under the ROC curve was 0.99 for procalcitonin, 0.62 for CRP and 0.60 for WBC. The cut off-concentrations for optimum prediction of severe bacterial diseases were： PCT 〉 2 μg/L sensitivity was 87% , both the specificity and positive predictive value were 100 %, negative predictive value 88 % and CRP 〉 20 mg/L. A sensitivity of 100% and negative predictive value of 100% were yielded and all patients with severe bacterial disease were identified when PCT〉0.9 μg/L. Conclusion In critically ill neonates the PCT concentration at admission is a better diagnostic marker of infection than CRP and WBC.
出处
《首都医科大学学报》
CAS
2005年第5期545-548,共4页
Journal of Capital Medical University
