摘要
目的探讨新生儿脐动脉血血清淀粉样蛋白A (SAA)、C-反应蛋白(CRP)水平变化并分析其临床意义,为临床早期有效诊断危重症新生儿提供参考依据。方法选取2015年2月-2017年2月在医院产科分娩的新生儿195例为研究对象,根据新生儿危重病例评分法将其分为正常对照组135例、非危重组22例、危重组23例及极危重组15例。所有新生儿断脐后采取脐动脉血,采用酶联免疫吸附法检测脐动脉血血清SAA与CRP水平,制作研究对象工作特性(ROC)曲线,计算SAA与CRP诊断危重症的敏感度与特异性。结果正常对照组、非危重组、危重组及极危重组新生儿的脐动脉血血清SAA、CRP水平均呈逐渐上升趋势,组间差异均有统计学意义(P<0. 05)。经Pearson相关性分析可得:新生儿脐动脉血血清SAA及CRP水平与危重症程度均呈正相关关系(P<0. 01)。新生儿脐动脉血血清SAA及CRP水平诊断危重症ROC曲线下面积分别为0. 941及0. 904。分别以新生儿脐动脉血血清SAA>1. 78 mg/L、CRP>24. 58 mg/L为最佳切入点,新生儿脐动脉血血清SAA、CRP水平诊断危重症的敏感度分别为84. 01%、72. 12%,特异性分别为96. 72%、90. 58%,约登指数分别为0. 802、0. 782。结论新生儿脐动脉血血清SAA、CRP水平均能有效反映危重症病情严重程度,且血清SAA及CRP水平在诊断危重症新生儿中均有较高的敏感度与特异性,可作为临床上诊断危重症新生儿的指标。
Objective To explore the changes of serum amyloid A (SAA) and C-reactive protein (CRP) levels in umbilical artery blood of neonates,analyze the clinical significance,and provide a reference basis for clinical early and effective diagnosis of critical diseases in neonates.Methods A total of 195 neonates bom in Department of Obstetrics in People's Hospital of Wuhan University from February 2015 to February 2017 were selected as study object,then they were divded into normal contrcl group (135 neonates),non-critical disease group (22 neonates),critical disease group (23 neonates),and very critical disease group (15 neonates) according to neonatal critical ill score.Umbilical artery blood samples were obtained after omphalotomy in the four groups.ELISA was used to detect the levels of serum SAA and CRP in umbilical artery blood.ROC was drawn to calculate sensitivities and specificities of SAA and CRP in diagnosis of critical diseases.Results The levels of serum SAA and CRP in umbilical artery blood of neonates in normal control group,non-critical disease group,critical disease group,and very critical disease group increased gradually (P<0.05).Pearson correlation analysis showed that the levels of serum SAA and CRP in umbilical artery blood of neonates were positively correlated with the severity of critical diseases (P<O.01).The areas under ROC curve of serum SAA and CRP in umbilical artery blood of neonates in diagnosis of critical diseases were 0.941 and 0.904,respectively.Taking serum SAA>1.78 mg/L and CRP>24.58 mg/L as the optimal incisiveness,the sensitivities of serum SAA and CRP in diagnosis of critical diseases were 84.01% and 72.12%,respectively,the specificities were 96.72% and 90.58%,respectively,Youden indexes were 0.802 and 0.782,respectively.Conclusion The levels of serum SAA and CRP in umbilical artery blood of neonates can effectively reflect the severity of critical diseases.The sensitivities and specificities of serum levels of SAA and CRP in diagnosis of critical diseases are high.SAA and CRP can be used as clinical indicators for clinical diagnosis of critical diseases in neonates.
作者
岑臻
张丙宏
CEN Zhen;ZHANG Bing-Hong.(Department of Neonatology,People's Hospital of Wuhan University,Wuhan,Hubei 430060,China)
出处
《中国妇幼保健》
CAS
2019年第7期1582-1585,共4页
Maternal and Child Health Care of China
基金
湖北省自然科学基金项目(2015CFB212)
