CAJ | 학술논문

目的：探讨新生儿脓毒症患儿血清降钙素原（procalcitonin，PCT）、C 反应蛋白（C－reactive proteinCRP）与新生儿危重病例评分（NCIS）的相关性，及 PCT 和 CRP 对预后判断的意义。方法选取新生儿脓毒症患儿79例，按 NCIS 评分标准分为极危重组（n＝17）、危重组（n＝36）和非危重组（n＝26）。入院24 h 内检测患儿血清 PCT、CRP 及血常规，依据患儿的治疗结局分为存活组（n＝65）和死亡组（n＝14），比较不同治疗结局、不同危重程度患儿的 PCT、CRP 及 NCIS 评分的差异，并分析PCT 及 CRP 与 NCIS 的相关性。结果非危重组 PCT 和 CRP 水平均低于危重组和极危重组（P ＜0．05），危重组 PCT 低于极危重组（P ＜0．05），极危重组患儿病死率显著高于危重组和非危重组（P ＜0．05）；PCT 与 CRP 呈明显正相关（r ＝0．71，P ＜0．05）；PCT、CRP 与 NCIS 评分均呈明显负相关（r ＝－0．53，r ＝－0．67，P ＜0．05）。死亡组 PCT 水平明显高于存活组（P ＜0．05），而 NCIS 评分明显低于存活组（P ＜0．05）。结论新生儿脓毒症患儿血清 CRP 和 PCT 与 NCIS 评分具有明显的相关性，NCIS 评分越低，血清 PCT 和 CRP 升高越明显。联合检测 PCT 和 CRP 的可预测新生儿脓毒症患儿病情及预后。
목적：탐토신생인농독증환인혈청강개소원（procalcitonin，PCT）、C 반응단백（C－reactive proteinCRP）여신생인위중병례평분（NCIS）적상관성，급 PCT 화 CRP 대예후판단적의의。방법선취신생인농독증환인79례，안 NCIS 평분표준분위겁위중조（n＝17）、위중조（n＝36）화비위중조（n＝26）。입원24 h 내검측환인혈청 PCT、CRP 급혈상규，의거환인적치료결국분위존활조（n＝65）화사망조（n＝14），비교불동치료결국、불동위중정도환인적 PCT、CRP 급 NCIS 평분적차이，병분석PCT 급 CRP 여 NCIS 적상관성。결과비위중조 PCT 화 CRP 수평균저우위중조화겁위중조（P ＜0．05），위중조 PCT 저우겁위중조（P ＜0．05），겁위중조환인병사솔현저고우위중조화비위중조（P ＜0．05）；PCT 여 CRP 정명현정상관（r ＝0．71，P ＜0．05）；PCT、CRP 여 NCIS 평분균정명현부상관（r ＝－0．53，r ＝－0．67，P ＜0．05）。사망조 PCT 수평명현고우존활조（P ＜0．05），이 NCIS 평분명현저우존활조（P ＜0．05）。결론신생인농독증환인혈청 CRP 화 PCT 여 NCIS 평분구유명현적상관성，NCIS 평분월저，혈청 PCT 화 CRP 승고월명현。연합검측 PCT 화 CRP 적가예측신생인농독증환인병정급예후。
Objective To investigate the correlation between serum levels of procalcitonin ( PCT) and C-reactive protein (CRP) and neonatal critical illness score ( NCIS) as well as their significance in judgment of severity and prognosis of neonates with sepsis.Methods Seventy-nine neonates with sepsis in the neonatal intensive care unit were enrolled.According to NCIS,these patients were divided into extremely critical (n =17),critical(n =36)and non-critical(n =26)groups.Within 24 hours after admission,serum levels of PCT and CRP,and routine blood counts were measured .These parameters were compared among the three groups .Based on clinical outcomes,these patients were divided into survival (n=65)and death groups(n=14).The PCT,CRP and NCIS were compared between the two groups.The Pearson correlation analysis was performed to determine the correlation between PCT /CRP and NCIS.Re-sults The serum levels of PCT and CRP in the non -critical group were significantly lower than those in the critical group and the ex -tremely critical groups(P <0.05).The two parameters were also significantly lower in the critical group than in that in the extremely critical groups(P <0.05).The extremely critical group had a significantly higher mortality than the critical and non -critical groups(P <0.05).Serum levels of PCT and CRP had a significantly negative correlation with NCIS (r=-0.53 and -0.67,P <0.05).Serum PCT levels had a significantly positive correlation with serum CRP levels (r=0.71,P <0.05).Compared with the death group ,the survival group had significantly higher serum levels of PCT (P <0.05)but a significantly lower NCIS(P <0.05).Conclusion For neonates with sepsis,the lower NCIS is,the higher the serum PCT level is.There are obvious correlations between serum levels of PCT /CRP and NCIS.A combination of serum PCT and NCIS can be used in judgment of severity and prognosis in neonates with sepsis .