CAJ | 학술논문

目的研究非感染因素对早产新生儿血清降钙素原的影响。方法选择北京军区总医院附属八一儿童医院早产儿重症监护中心2012年1月至2012年12月期间收治入院的胎龄为33～36周、出生时间小于12小时、无胎膜早破因素的非感染性疾病早产儿为研究对象。所有患儿入院后即采血进行血常规、C反应蛋白、血培养及降钙素原检查。非感染性疾病患儿包括新生儿颅内出血（ICH）、新生儿呼吸窘迫综合征（NRDS）、新生儿窒息及对照组单纯早产儿。动态监测各组患儿血常规、C反应蛋白、血培养、降钙素原等指标，并比较各组患儿降钙素原浓度，通过统计分析各组早产新生儿的血清降钙素原浓度，以研究不同非感染性疾病对其血清降钙素原浓度的影响。结果①同目前文献推荐的血清降钙素原浓度（<0.5 ng/ml）相比，早产新生儿生后血清降钙素原浓度有生理性升高（1.07±0.76）ng/ml。②ICH组（2.12±0.99）ng/ml、NRDS组（2.28±1.09）ng/ml、新生儿窒息组（3.64±3.17）ng/ml降钙素原水平较对照组（1.07±0.76） ng/ml均升高（F=10.462，P<0.05）。不同程度的ICH间降钙素原差异无显著性（F=0.173,P=0.950）；Ⅱ级、Ⅲ级NRDS降钙素原水平较Ⅰ级NRDS升高（F=5.475,P=0.010）；重度窒息组降钙素原水平较轻度窒息组明显升高(t=5.245,P=0.003)。结论早产儿生后降钙素原浓度有生理性升高。降钙素原受多种因素影响，ICH、NRDS、新生儿窒息可导致早产新生儿降钙素原浓度升高，在早产新生儿中不能单纯依靠降钙素原水平评价早产儿感染情况。
목적연구비감염인소대조산신생인혈청강개소원적영향。방법선택북경군구총의원부속팔일인동의원조산인중증감호중심2012년1월지2012년12월기간수치입원적태령위33～36주、출생시간소우12소시、무태막조파인소적비감염성질병조산인위연구대상。소유환인입원후즉채혈진행혈상규、C반응단백、혈배양급강개소원검사。비감염성질병환인포괄신생인로내출혈（ICH）、신생인호흡군박종합정（NRDS）、신생인질식급대조조단순조산인。동태감측각조환인혈상규、C반응단백、혈배양、강개소원등지표，병비교각조환인강개소원농도，통과통계분석각조조산신생인적혈청강개소원농도，이연구불동비감염성질병대기혈청강개소원농도적영향。결과①동목전문헌추천적혈청강개소원농도（<0.5 ng/ml）상비，조산신생인생후혈청강개소원농도유생이성승고（1.07±0.76）ng/ml。②ICH조（2.12±0.99）ng/ml、NRDS조（2.28±1.09）ng/ml、신생인질식조（3.64±3.17）ng/ml강개소원수평교대조조（1.07±0.76） ng/ml균승고（F=10.462，P<0.05）。불동정도적ICH간강개소원차이무현저성（F=0.173,P=0.950）；Ⅱ급、Ⅲ급NRDS강개소원수평교Ⅰ급NRDS승고（F=5.475,P=0.010）；중도질식조강개소원수평교경도질식조명현승고(t=5.245,P=0.003)。결론조산인생후강개소원농도유생이성승고。강개소원수다충인소영향，ICH、NRDS、신생인질식가도치조산신생인강개소원농도승고，재조산신생인중불능단순의고강개소원수평평개조산인감염정황。
Objective To study the effect of non-infectious factors on serum procalcitonin(PCT) in preterm neonates.MethodThe premature infants of neonatal intensive care unit(NICU) in our hospital were chosen from gestational age ranged from 33 to 36 weeks, birth time less than 12 hours without premature rupture and hospitalization period from January 2012 to December 2012. All of the premature infants were <br> drawn blood immediately admitted to hospital and C-reactive protein (CRP), blood cultures and procalcitonin were tested. The types of premature infants non-infectious diseases included intracranial hemorrhage (ICH), neonatal respiratory distress syndrome (NRDS), neonatal asphyxia and the control group (preterm infants) without disease. The blood routine , C-reactive protein, blood culture, procalcitonin and other infections indicators in each group were monitored dynamicly in order to study the impact of these non-infectious diseases on serum procalcitonin concentrations by statistical analysis.Results ① Compared with the current literature recommended serum procalcitonin concentrations (<0.5ng / ml), procalcitonin concentrations in preterm neonates singniifcantly increase (1.07± 0.76) ng / ml.②Compared with control group (1.07±0.76) ng/ml,the procalcitonin levels in intracranial hemorrhage group (2.12± 0.99) ng/ml, neonatal respiratory distress syndrome group (2.28±1.09) ng/ml and asphyxia group (3.64± 3.17) ng / ml signiifcantly increased (F= 10.462,P <0.05).There were no signiifcant differences (F= 0.173,P= 0.950) among the different levels of intracranial hemorrhage group; Compared with the ifrst grade NRDS , the procalcitonin leves in second grade and third grade NRDS groups were significantly increased (F=5.475,P= 0.010); The procalciton level in severe asphyxia group was signiifcantly higher than in mild asphyxia group (t= 5.245,P= 0.003). Conclusions The procalcitonin concentration physiologically increased after preterm neonates were born. Many factors such as intracranial hemorrhage, neonatal respiratory distress syndrome and neonatal asphyxia can increase procalcitonin concentration so the level of PCT levels can not evaluate accurately preterm children infection.