摘要
目的探讨降钙素原(PCT)与新生儿败血症的相关性。方法选取2015年2月至2018年2月宝鸡市人民医院收治的100例败血症新生儿。对所有患儿按病原菌分组:革兰氏阴性(G^-)菌组37例,革兰氏阳性(G^+)菌组41例,真菌组22例;按新生儿危重评分组:非危重组41例,危重组28例,极危重组31例;按脏器受累程度分组:无脏器功能障碍组35例,单一脏器功能障碍组26例,多脏器功能障碍或休克组39例;按预后分组:死亡组7例,存活组93例。所有患儿在入住新生儿重症监护病房(NICU)当天在其不同部位采集双份血进行培养检测,同时进行血气分析、凝血功能、生化、C反应蛋白(CRP)、PCT及血常规等检查,在24小时内根据患儿的最异常检测值对其进行新生儿危重评分,并对结果进行统计分析。结果 G^-菌组PCT、CRP和中性粒细胞/淋巴细胞比值(NLR)水平均高于G^+菌组和真菌组(t=3.874~73.243,均P<0.05)。不同新生儿危重评分组CRP和PCT水平比较差异均有统计学意义(t=10.743~63.224,均P<0.01)。不同脏器受累程度组CRP和PCT水平比较差异均有统计学意义(t=3.237~89.432,均P<0.05)。死亡组PCT水平显著高于存活组(t=86.618,P<0.01)。经Pearson相关性分析发现,患儿NLR、CRP、PCT与新生儿危重评分均有负相关关系(r值分别为-0.443、-0.436、-0.462,均P<0.01)。结论相对于NLR和WBC、CRP等指标而言,PCT对新生儿败血症的脏器受累程度、病情严重程度、预后等具有更高的评估价值,值得在临床上加以推广运用。
Objective To analyze the correlation between PCT and neonatal septicemia.Methods 100 newborns with sepsis admitted to Baoji People’s Hospital from February 2015 to February 2018 were recruited for the study.All the children were grouped into pathogenic groups:there were 37 cases in the gram negative(G^-) bacterial group,41 cases in the gram positive(G^+) bacterial group,and 22 cases in the fungus group.According to the critical evaluation grouping of newborns,there were 41 cases in the non-critical group,28 cases in the critical group,and 31 cases in the extremely critical group.According to the involvement degree of viscera,there were 35 cases in the group without viscera dysfunction,26 cases in the group with single viscera dysfunction,and 39 cases in the group with multiple viscera dysfunction or shock.If the newborns were grouped according to prognosis,there were 7 cases in the death group and 93 cases in the survival group.All children were admitted into the neonatal intensive care unit(NICU) and dual samples of blood were taken from the different parts of the newborns on the same day for double blood culture tests,and blood gas analysis,blood coagulation function,biochemistry,C-reactive protein(CRP),PCT and blood routine examination were done according to the children of the abnormal values within 24 hours on the critically ill newborn grading,and the results were analyzed.Results PCT,CRP and neutrophil/lymphocyte ratio(NLR) of G^- bacteria group were higher than those of G^+ bacteria group and fungus group(t=3.874-73.243,P<0.05 for all).There were significant differences in CRP and PCT levels(t=10.743-63.224,all P<0.01).There were significant differences in CRP and PCT levels between the groups with different visceral involvement(t=3.237-89.432,P<0.05 for all).PCT levels in the death group were significantly higher than those in the survival group(t=86.618,P<0.01).Pearson correlation analysis showed that there was a negative correlation between NLR,CRP,PCT and neonatal critical score(r=-0.443,-0.436,-0.462,respectively.P<0.01 for all).Conclusion Compared with NLR,WBC,CRP and other indicators,PCT has a higher evaluation value for the visceral involvement,severity and prognosis of neonatal sepsis,which is worthy to be popularized and applied in clinical practice.
作者
李园
齐荣
程雨嘉
唐瑾
LI Yuan;QI Rong;CHENG Yujia;TANG Jin(Department of Neonatology,Baoji Peopled Hospital,Baoji 721000,Shaanxi,China)
出处
《中国妇幼健康研究》
2019年第10期1196-1200,共5页
Chinese Journal of Woman and Child Health Research
