CAJ | 학술논문

目的：探讨血清降钙素原（PCT）、超敏-C反应蛋白（hs-CRP）、白介素-6（IL-6）和白细胞（WBC）计数共四项检测项目在早期诊断新生儿败血症中的方法学评价。方法选取2013.6.1～8.31期间新生儿科败血症患儿84例，正常新生儿140例，采用电化学发光法测定患儿血清的PCT和 IL-6水平，散射比浊法测定 hs-CRP水平，同时用 XE-2100检测患儿全血的白细胞。结果败血症患儿的血清 PCT，hs-CRP 及 IL-6和正常新生儿相比差异有统计学显著性意义（t＝6.37～10.58，P＜0.01），而 WBC在二者之间比较差异无统计学意义（t＝3.15，P＞0.05）。而 PCT，IL-6和 hs-CRP三项联合检测诊断新生儿败血症的灵敏度为98.81％，特异度为90.24％，高于其中任何一单项检测的灵敏度和特异度；同时 PCT在检测新生儿败血症，0.5 ng／ml≤PCT≤2 ng／ml时，以革兰阳性菌感染为主；PCT＞2 ng／ml时以革兰阴性菌感染为主，革兰阳性菌感染和革兰阴性菌感染比较差异有统计学意义（χ2＝4.646.37～35.05，P＜0.05）。结论 PCT，hs-CRP和 IL-6的检测可用于新生儿败血症的早期临床诊断，具有灵敏度高、特异性强等特点，为早期的新生儿败血症的诊断和治疗提供依据。
목적：탐토혈청강개소원（PCT）、초민-C반응단백（hs-CRP）、백개소-6（IL-6）화백세포（WBC）계수공사항검측항목재조기진단신생인패혈증중적방법학평개。방법선취2013.6.1～8.31기간신생인과패혈증환인84례，정상신생인140례，채용전화학발광법측정환인혈청적PCT화 IL-6수평，산사비탁법측정 hs-CRP수평，동시용 XE-2100검측환인전혈적백세포。결과패혈증환인적혈청 PCT，hs-CRP 급 IL-6화정상신생인상비차이유통계학현저성의의（t＝6.37～10.58，P＜0.01），이 WBC재이자지간비교차이무통계학의의（t＝3.15，P＞0.05）。이 PCT，IL-6화 hs-CRP삼항연합검측진단신생인패혈증적령민도위98.81％，특이도위90.24％，고우기중임하일단항검측적령민도화특이도；동시 PCT재검측신생인패혈증，0.5 ng／ml≤PCT≤2 ng／ml시，이혁란양성균감염위주；PCT＞2 ng／ml시이혁란음성균감염위주，혁란양성균감염화혁란음성균감염비교차이유통계학의의（χ2＝4.646.37～35.05，P＜0.05）。결론 PCT，hs-CRP화 IL-6적검측가용우신생인패혈증적조기림상진단，구유령민도고、특이성강등특점，위조기적신생인패혈증적진단화치료제공의거。
Objective To investigate the serum procalcitonin (PCT),interleukin-6 (IL-6 ),hypersensitive C-reactive protein (hs-CRP)and white blood cells (WBC)joint detection in the value of early clinical diagnosis of neonatal sepsis.Methods Choose 84 cases with sepsis and 140 cases of mormal newborn in children between 2013.6.1~2013.8.31.Used the electro-chemical luminescence method and scattering turbidimetric method to detect levels of serum PCT,IL-6 and hs-CRP respec-tively,at the same time test whole blood white cells with XE-2100 instrument.Results There were significant difference be-tween serum levels of PCT,hs-CRP and IL-6 of the patients with sepsis and normal newborns (t=6.37~10.58,P<0.01) and no statistically significant difference for WBC (t=3.15,P>3.15).But joint detection of PCT,IL-6 and hs-CRP for neo-natal sepsis,the sensitivity was 98.81%,specificity was 90.24%,higher than any of them a detection sensitivity and special-ity degree.PCT in detection of neonatal sepsis,when 0.5 ng/ml≤PCT≤2 ng/ml,it was priority to with gram-positive bac-terium infection,and when PCT>2 ng/ml,was priority to with gram-negative bacteria infection,compared G+ bacteria infec-tion and G- bacteria infection,the difference was statistically significant (χ2=4.646.37~35.05,P<0.05).Conclusion PCT,hs-CRP and IL-6 detection has high sensitivity,strong specificity,they can provide evidence for early diagnosis and treatment of neonatal sepsis.