CAJ | 학술논문

目的：评价新生儿肺炎合并脓毒症患儿检测血清降钙素原（PCT）、高敏C反应蛋白（hs-CRP）的临床价值，并探讨其血清含量与新生儿脓毒症严重程度的相关性。方法分别采用免疫荧光法和散射比浊法测定216例新生儿肺炎患儿（其中非脓毒症119例、轻度脓毒症69例、严重脓毒症28例）血清 PCT 和 hsCRP 含量。绘制受试者工作特征（ROC）曲线，分析 PCT、hs-CRP 对肺炎合并轻度脓毒症和严重脓毒症的诊断价值。结果非脓毒症、轻度脓毒症和严重脓毒症患儿 PCT、hs-CRP 水平依次升高，各组间差异均有统计学意义（P 均＜0．01）。PCT、hs-CRP 诊断肺炎合并轻度脓毒症和严重脓毒症的 ROC 曲线下面积分别为0．853、0．772。PCT 和hs-CRP 分别以≥2 ng/mL 和≥55 mg/L 为截点诊断肺炎合并严重脓毒症的性能最佳，敏感性分别为71．43％和82．14％、特异性分别为75．00％和53．57％；若两者联合诊断，敏感性和特异性分别为89．29％和85．71％。PCT和 hs-CRP 在新生儿肺炎合并脓毒症患儿治疗前后差异有统计学意义（P ＜0．05）。结论PCT 和 hs-CRP 对判断新生儿肺炎合并脓毒症严重程度有较高的应用价值，其中 PCT 比 hs-CRP 更能反映脓毒症的严重程度。联合检测 PCT 和 hs-CRP 对新生儿肺炎合并脓毒症的早期诊断、疗效观察和预后判断有较高的价值。
목적：평개신생인폐염합병농독증환인검측혈청강개소원（PCT）、고민C반응단백（hs-CRP）적림상개치，병탐토기혈청함량여신생인농독증엄중정도적상관성。방법분별채용면역형광법화산사비탁법측정216례신생인폐염환인（기중비농독증119례、경도농독증69례、엄중농독증28례）혈청 PCT 화 hsCRP 함량。회제수시자공작특정（ROC）곡선，분석 PCT、hs-CRP 대폐염합병경도농독증화엄중농독증적진단개치。결과비농독증、경도농독증화엄중농독증환인 PCT、hs-CRP 수평의차승고，각조간차이균유통계학의의（P 균＜0．01）。PCT、hs-CRP 진단폐염합병경도농독증화엄중농독증적 ROC 곡선하면적분별위0．853、0．772。PCT 화hs-CRP 분별이≥2 ng/mL 화≥55 mg/L 위절점진단폐염합병엄중농독증적성능최가，민감성분별위71．43％화82．14％、특이성분별위75．00％화53．57％；약량자연합진단，민감성화특이성분별위89．29％화85．71％。PCT화 hs-CRP 재신생인폐염합병농독증환인치료전후차이유통계학의의（P ＜0．05）。결론PCT 화 hs-CRP 대판단신생인폐염합병농독증엄중정도유교고적응용개치，기중 PCT 비 hs-CRP 경능반영농독증적엄중정도。연합검측 PCT 화 hs-CRP 대신생인폐염합병농독증적조기진단、료효관찰화예후판단유교고적개치。
Objective To assess the clinical significance of serum procalcitonin (PCT)and high-sensitivity C reactive protein(hs-CRP)in neonatal pneumonia and sepsis patients,and to investigate the correlation of the levels of serum PCT and hs-CRP with the severity of neonatal sepsis.Methods A total of 21 6 neonatal pneumonia patients were enrolled and classified into 3 groups,including 1 1 9 cases of non-sepsis,69 cases of mild sepsis and 28 cases of severe sepsis.The levels of serum PCT and hs-CRP were determined by immunofluorescence and turbidimetric method.By receiver operating characteristic (ROC)curve,the diagnosis significances of PCT and hs-CRP for mild sepsis and severe sepsis with pneumonia were analyzed.Results PCT and hs-CRP levels in non-sepsis,mild sepsis and severe sepsis patients increased,and there was statistical significance (P <0.01 ).The areas under ROC curves of PCT and hs-CRP for the diagnosis of pneumonia with mild sepsis and severe sepsis were 0.853 and 0.772.PCT ≥ 2 ng/mL and hs-CRP≥ 55 mg/L were optimal cut-off values for the diagnosis of pneumonia with severe sepsis,the sensitivities were 71 .43%and 82.1 4%,and the specificities were 75.00% and 53.57%,respectively.If the combined determination was performed,the sensitivity and specificity were 89.29% and 85.71 %.PCT and hs-CRP levels were statistically significant before and after the treatment for neonatal pneumonia and sepsis patients (P <0.05).Conclusions PCT and hs-CRP have high application significance to judge the neonatal pneumonia and sepsis severity,and PCT can reflect the sepsis more clearly than hs-CRP.The combined determination of PCT and hs-CRP has high significance for the early diagnosis,observation of curative effect and prognosis on neonatal pneumonia and sepsis.