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目的探讨降钙素原(PCT)、超敏C反应蛋白(CRP)和白细胞(WBC)水平在新生儿感染性肺炎中的表达情况,并分析三者联合检测的临床诊断价值。方法选取2013年3月~2014年11月在该院住院治疗的感染性肺炎新生儿157例为研究组,并根据感染性质不同将其分为细菌组(细菌性感染)47例、混合组(混合性感染)30例和其他组80例。另选取同期无感染疾病的健康新生儿157例为健康组。比较各组血清中PCT、CRP水平和WBC计数结果。结果联合检测对研究组、细菌组、混合组与其他组的灵敏度分别为81.5%、95.2%、86.1%、10.5%;特异度分别为73.5%、89.2%、71.0%、61.0%;联合检测灵敏度与特异度分别为81.5%与73.5%。PCT和CRP在细菌组和混合组中显著上升(P<0.05);治疗前后均有显著性改变(P<0.05)。WBC仅在细菌组显著上升(P<0.05),改变幅度小于PCT和CRP,但治疗前后仍有显著性改变(P<0.05)。其他组3项指标无显著改变。结论 PCT的灵敏度高于CRP和WBC,三者联合检测可以有效执行对细菌性/混合性肺炎的鉴别诊断和疗效监测,能以组合模式构建新生儿肺炎的血清学感染指标,值得临床推广使用。
Objective To investigate the expression of procalcitonin (PCT), high-sensitivity C-reactive protein (CRP) and white blood cell (WBC) in neonatal pneumonia and to analyze the clinical diagnostic value of combined detection of the three. Methods A total of 157 neonates with infectious pneumonia admitted to our hospital from March 2013 to November 2014 were selected as the study group. According to the different nature of infection, they were divided into bacterial group (bacterial infection) in 47 cases, mixed group Mixed infection) 30 cases and other 80 cases. Another 157 healthy newborns with no infectious diseases in the same period were selected as the healthy group. The serum PCT, CRP levels and WBC count results were compared. Results The sensitivity of combined detection was 81.5%, 95.2%, 86.1% and 10.5% respectively in the study group, bacteria group, mixed group and other groups. The specificity was 73.5%, 89.2%, 71.0% and 61.0% The specificities were 81.5% and 73.5% respectively. PCT and CRP were significantly increased in both bacterial and mixed groups (P <0.05), with significant changes before and after treatment (P <0.05). WBC increased only significantly in the bacterial group (P <0.05), and the change range was smaller than that of PCT and CRP. However, WBC was still significantly changed before and after treatment (P <0.05). No significant change was observed in the other three indicators. Conclusions The sensitivity of PCT is higher than that of CRP and WBC. Combined detection of PCT and PCT can effectively perform the differential diagnosis and curative effect monitoring of bacterial / mixed pneumonia, and can construct serological infection index of neonatal pneumonia in combinatorial mode, which is worthy of clinical promotion.