CAJ | 학술논문

目的：探讨降钙素原（PCT）、C反应蛋白（CRP）、心肌酶联合检测在新生儿高胆红素血症诊断中的价值。方法收集该院确诊的由败血症、肺炎、ABO溶血、母乳性黄疸导致的新生儿高胆红素血症患者各30例，新生儿肝炎和低体质量早产儿引发的新生儿高胆红素血症患者各20例。选取同期本院产科足月健康新生儿30例作为对照组。对上述纳入对象进行PCT、CRP、心肌酶[包括天门冬氨酸氨基转移酶（AST）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）]水平的检测和分析。结果与对照组比较，新生儿高胆红素血症细菌感染组PCT、CRP水平升高（P＜0．05）；心肌酶浓度在感染组和非感染组均升高（P＜0．05）；细菌感染组、早产儿组及溶血症组CK-MB水平显著升高（P＜0．01），母乳性黄疸组和肝炎组CK-MB水平也升高（P＜0．05）；肝炎组AST 、LDH活性显著升高（P＜0．01）。PCT 在细菌性感染组中的诊断特异度明显高于CRP（P＜0．05），而在肺炎组中灵敏度显著低于CRP（P＜0．01）。结论 PCT、CRP、心肌酶的变化与新生儿高胆红素血症的发生、发展有密切的关系，这几项指标的检测可互为补充。
목적：탐토강개소원（PCT）、C반응단백（CRP）、심기매연합검측재신생인고담홍소혈증진단중적개치。방법수집해원학진적유패혈증、폐염、ABO용혈、모유성황달도치적신생인고담홍소혈증환자각30례，신생인간염화저체질량조산인인발적신생인고담홍소혈증환자각20례。선취동기본원산과족월건강신생인30례작위대조조。대상술납입대상진행PCT、CRP、심기매[포괄천문동안산안기전이매（AST）、기산격매（CK）、기산격매동공매（CK-MB）、유산탈경매（LDH）]수평적검측화분석。결과여대조조비교，신생인고담홍소혈증세균감염조PCT、CRP수평승고（P＜0．05）；심기매농도재감염조화비감염조균승고（P＜0．05）；세균감염조、조산인조급용혈증조CK-MB수평현저승고（P＜0．01），모유성황달조화간염조CK-MB수평야승고（P＜0．05）；간염조AST 、LDH활성현저승고（P＜0．01）。PCT 재세균성감염조중적진단특이도명현고우CRP（P＜0．05），이재폐염조중령민도현저저우CRP（P＜0．01）。결론 PCT、CRP、심기매적변화여신생인고담홍소혈증적발생、발전유밀절적관계，저궤항지표적검측가호위보충。
Objective To investigate the clinical value of joint detection of procalcitoninl (PCT ) ,C-reactive protein (CRP) ,and myocardial enzymes in patients with neonatal hyperbilirubinemia .Methods 30 cases of each cause were included in the study ,which were neonatal hyperbilirubinemia caused by sepsis ,pneumonia ,ABO hemolytic and breast milk jaundice .20 cases of each cause were selected including neonatal hyperbilirubinemia caused by neonatal hepatitis and low birth weight infants .All the cases involved in the study were diagnosed .30 healthy full-term newborns in the same period were recruited as control group .PCT ,CRP and myocar-dial enzymes (AST ,CK ,CK-MB ,and LDH) concentration in serum were determined .Results Compared with the control group , CRP and PCT concentration increased significantly in bacterial infected group (P< 0 .05) .Myocardial enzyme concentration in-creased significantly both in infected group and non-infected group(P<0 .05) .Among myocardial enzymes ,CK-MB concentration increased significantly in bacterial infected group ,low birth weight infants group and ABO hemolytic group(P<0 .01) and increased significantly in breast milk jaundice group and hepatitis group (P<0 .05) .AST and LDH concentration increased very significantly in hepatitis group(P<0 .01) .The specificity of PCT in bacterial infected group was significantly higher than that of CRP (P<0 .05) ,while its sensitivity was significantly lower than that of CRP in pneumonia group (P<0 .01) .Conclusion Changes of PCT , CRP and myocardial enzymes concentration are related to the occurrence and development of neonatal hyperbilirubinemia ,determi-nation of these indicators can be complementary .