摘要
目的探讨降钙素原(PCT)、C反应蛋白(CRP)在新生儿血流感染诊断中的价值,为血流感染的早期诊断和抗菌药物治疗提供依据。方法选取血培养阳性且行PCT、CRP检测的患儿55例为实验组,以血培养阴性、临床诊断为非血流感染的患儿55例为对照组。实验组根据血培养结果再分为革兰阳性菌组和革兰阴性菌组。对比各组PCT、CRP检测结果。采用受试者工作特征(ROC)曲线评估PCT、CRP诊断血流感染的效能。结果实验组PCT水平为0.65(0.25~7.0)ng/m L,显著高于对照组[0.17(0.12~0.24)ng/m L](P=0.000);CRP水平为10.97(1.04~23.82)mg/L,高于对照组[2.49(0.62~9.62)mg/L,P=0.002]。革兰阴性菌组PCT水平高于革兰阳性菌组(P<0.05),而2个组之间CRP水平差异无统计学意义(P>0.05)。ROC曲线分析显示,以PCT=0.245 ng/m L为诊断新生儿血流感染的临界值,其敏感性、特异性、阳性预测值、阴性预测值和准确度分别为76.4%、78.2%、77.8%、76.8%和77.3%,曲线下面积(AUC)为0.830;以CRP=9.185 mg/L为诊断新生儿血流感染的临界值,其敏感性、特异性、阳性预测值、阴性预测值和准确度分别为56.4%、72.7%、67.4%、62.5%和64.5%,AUC为0.669。结论 PCT和CRP检测对新生儿血流感染的诊断有一定价值。PCT的敏感性、特异性优于CRP。革兰阴性菌血流感染者的PCT水平较革兰阳性菌血流感染者高。
Objective To investigate the roles of procalcitonin(PCT)and C-reactive protein(CRP)in the diagnosis of neonatal bloodstream infection,and to provide a reference for the early diagnosis and antibiotic treatment of bloodstream infection.Methods A total of 55 patients with blood culturing positive were enrolled as experimental group,and they were determined for PCT and CRP.Totally,55 cases with blood culturing negative confirmed by clinical diagnosis in the same period were enrolled as control group.The experimental group were subclassified according to Gram-positive and Gram-negative bacteria,and the difference of PCT and CRP levels among these groups was compared.The efficiencies of PCT and CRP for the diagnosis of neonatal bloodstream infection were analyzed and compared according to receiver operating characteristic(ROC)curve.Results In the experimental group,PCT was 0.65(0.25-7.00)ng/mL,which was higher than that in control group[0.17(0.12-0.24)ng/mL](P=0.000).CRP in the experimental group was 10.97(1.04-23.82)mg/L,and that in control group was 2.49(0.62-9.62)mg/L(P=0.002).The PCT in Gram-negative bacteria was higher than that in Gram-positive bacteria(P<0.05),and CRP level had no statistical significance between the 2 subgroups(P>0.05).ROC curve analysis showed that when PCT was 0.245 ng/mL as the cut-off value of neonatal bloodstream infection,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 76.4%,78.2%,77.8%,76.8%and 77.3%.The area under curve(AUC)was 0.830.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 56.4%,72.7%,67.4%,62.5%and 64.5%,respectively,when CRP was 9.185 mg/L as the cut-off value of neonatal bloodstream infection.The AUC was 0.669.Conclusions The determinations of PCT and CRP play roles in diagnosing neonatal bloodstream infection.The sensitivity and specificity of PCT determination are superior to those of CRP determination.PCT level is high in bloodstream infection patients infected with Gram-negative bacteria than that with Gram-positive bacteria.
作者
王昭蓉
邵雪峰
WANG Zhaorong;SHAO Xuefeng(Department of Clinical Laboratory,Nantong Maternal and Child Health Care Service Center,Nantong 226018,Jiangsu,China)
出处
《检验医学》
CAS
2018年第7期608-611,共4页
Laboratory Medicine
关键词
降钙素原
C反应蛋白
革兰阴性菌
革兰阳性菌
血流感染
Procalcitonin
C-reactive protein
Gram-negative bacterium
Gram-positive bacterium
Bloodstream infection
