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目的:探讨血清降钙素原(PCT)及C反应蛋白(CRP)在新生儿社区获得性肺炎(CAP)中的应用价值。方法:选取该院新生儿274名,分为细菌组、病毒组和健康组。按照国际血液学标准化委员会(ICSH)制定的评价标准,分别采用电化学发光法,免疫比浊法对PCT和CRP进行检测分析。结果:细菌组与病毒组PCT、CRP和WBC之间比较分别为PCT(F=21.349,P<0.05)、CRP(F=234.988,P<0.05)、WBC(F=73.96,P<0.05);细菌组与健康组比较,差异有统计学意义PCT(F=21.390,P<0.05)、CRP(F=262.365,P<0.05)、WBC(F=87.235,P<0.05);病毒组PCT、CRP与健康组比较,差异无统计学意义,PCT(F=3.032,P>0.05)、CRP(F=2.684,P>0.05)。细菌组中PCT、CRP两种不同的检测指标来诊断细菌感染的敏感性和特异性进行χ2检验,差异有统计学意义(χ2=11.812,P<0.05)。以PCT>0.5 ng/ml为界,诊断细菌感染的敏感性为80.4%(74/92),特异性为96.6%(86/89),以CRP>8 mg/L为界,诊断细菌感染的敏感性为67.4%(62/92),特异性为92.1%(82/89)。结论:PCT检测是判断新生儿社区获得性肺炎(CAP)的良好指标,不仅对全身细菌感染诊断具有良好的敏感性和特异性,而且能动态监测患者病情变化、反映感染的严重程度,为临床医师评估病情转归提供客观依据;血清PCT检测结果可反映抗菌药物的疗效,能为临床医师及时调整抗菌药物提供依据,应尽早开展PCT和CRP检测。
Objective: To investigate the value of serum procalcitonin (PCT) and C-reactive protein (CRP) in neonatal community-acquired pneumonia (CAP). Methods: 274 newborns in this hospital were selected and divided into bacteria group, virus group and healthy group. According to the evaluation criteria set by International Commission of Hematology (ICSH), electrochemiluminescence and immunoturbidimetric assay were used to detect PCT and CRP respectively. Results: The comparison of PCT, CRP and WBC in bacterial group and virus group were PCT (F = 21.349, P <0.05), CRP (F = 234.988, P <0.05) and WBC (F = 73.96, The difference between the bacterial group and the healthy group was statistically significant (P <0.05), the difference was statistically significant (P <0.05), CRP (F = 262.365, Compared with healthy group, the difference was not statistically significant (P> 0.05), CRP (F = 2.684, P> 0.05). The sensitivity and specificity of PCT and CRP in bacterial group to diagnose bacterial infection were tested byχ2 test, the difference was statistically significant (χ2 = 11.812, P <0.05). The sensitivity, specificity and accuracy of bacterial infection were 80.4% (74/92) and 96.6% (86/89), respectively, with PCT> 0.5 ng / ml as the boundary. The diagnosis of bacterial infection was based on CRP> 8 mg / L The sensitivity was 67.4% (62/92) and the specificity was 92.1% (82/89). Conclusion: The PCT test is a good indicator of neonatal community-acquired pneumonia (CAP). It not only has good sensitivity and specificity for the diagnosis of systemic bacterial infection, but also can dynamically monitor the patient’s condition changes, reflecting the severity of infection, clinical The assessment of the prognosis by physicians provides an objective basis. The serum PCT test results can reflect the efficacy of antimicrobial agents and provide the basis for clinicians to timely adjust antimicrobial drugs. PCT and CRP testing should be carried out as soon as possible.