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目的:探讨血清C反应蛋白(CRP)、可溶性人髓系细胞触发受体-1(s-TREM-1)和降钙素原(PCT)检测对识别新生儿严重细菌感染(SBI)的有效性。方法:选择本院121例疑似SBI的新生儿,其中25例确诊为SBI患儿,96例为非SBI患儿。测定患儿血清CRP、s-TREM-1和PCT水平,并采用受试者工作特征曲线(ROC曲线)分析不同炎症标志物诊断新生儿SBI的敏感性和特异性。结果:SBI组血清CRP、PCT水平均高于非SBI组(均P<0.05)。CRP、s-TREM-1和PCT的敏感性分别为86.4%、84.0%和58.2%,特异性分别为52.0%、50.9%和76.8%。结论:血清CRP、s-TREM-1、PCT检测并不能很好地协助临床精确性诊断新生儿SBI,但是CRP、s-TREM-1和PCT联合检测可以有效地提高诊断灵敏性和特异性,其鉴别诊断价值尚须进一步确定。
Objective: To investigate the effectiveness of detecting serum C-reactive protein (CRP), soluble human myeloid cell trigger receptor-1 (s-TREM-1) and procalcitonin (PCT) in identifying neonatal severe bacterial infections . Methods: A total of 121 newborns suspected of having SBI were selected. Among them, 25 were diagnosed as SBI and 96 were non-SBI. The serum levels of CRP, s-TREM-1 and PCT in children were measured. The sensitivity and specificity of different inflammatory markers in the diagnosis of neonatal SBI were analyzed by receiver operating characteristic curve (ROC curve). Results: Serum CRP and PCT levels in SBI group were significantly higher than those in non-SBI group (all P <0.05). The sensitivities of CRP, s-TREM-1 and PCT were 86.4%, 84.0% and 58.2%, respectively, and the specificity were 52.0%, 50.9% and 76.8% respectively. Conclusion: Serum CRP, s-TREM-1 and PCT tests do not help clinical diagnosis of neonatal SBI. However, the combined detection of CRP, s-TREM-1 and PCT can effectively improve the diagnostic sensitivity and specificity, The differential diagnosis value still needs to be further confirmed.