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目的探讨血清C反应蛋白(CRP)、降钙素原(PCT)、血小板计数(PLT)对诊断新生儿败血症的应用价值,为临床快速准确诊断提供依据。方法选用临床诊断的新生儿败血症患儿60例为研究组,另选同期无并发症的新生儿肺炎60例为对照组。用免疫比浊法测CRP、电化学发光法测PCT、全自动血细胞分析仪测PLT,比较两组的CRP、PCT、PLT水平,同时以CRP>8mg/L、PCT>2.0ng/m L、PLT<100×109/L作为阳性阈值,观察各指标独立及联合诊断新生儿败血症的灵敏度、特异度、阳性预测值、阴性预测值及约登指数。结果新生儿败血症组的CRP、PCT水平明显高于对照组,差异有统计学意义(P<0.05),PLT水平明显低于对照组,差异有统计学意义(P<0.05)。PCT的灵敏度、特异度、阳性预测值、阴性预测值及约登指数均优于CRP、PLT,而三个指标联合诊断的灵敏度优于各指标独立诊断。结论 CRP、PCT、PLT对新生儿败血症有很好的临床诊断价值,联合检测能够提高对新生儿败血症的早期诊断水平。
Objective To investigate the clinical value of serum C-reactive protein (CRP), procalcitonin (PCT) and platelet count (PLT) in the diagnosis of neonatal sepsis and provide the basis for rapid and accurate clinical diagnosis. Methods Sixty children with neonatal sepsis were selected as the study group and 60 neonates with pneumoconiosis without complications were selected as the control group. The levels of CRP, PCT and PLT were compared between the two groups by CRP, PCT and PLT, PCT> 2.0mg / L, PLT <100 × 109 / L as a positive threshold to observe the sensitivity and specificity, positive predictive value, negative predictive value and Youden index of each index independently and jointly diagnosed neonatal sepsis. Results The levels of CRP and PCT in neonatal sepsis group were significantly higher than those in control group (P <0.05). The PLT level in neonatal sepsis group was significantly lower than that in control group (P <0.05). PCT sensitivity, specificity, positive predictive value, negative predictive value and Youden index were better than CRP, PLT, and the sensitivity of the three indicators combined diagnosis is better than the independent diagnosis of each indicator. Conclusion CRP, PCT and PLT have good clinical value in diagnosis of neonatal sepsis. Combined testing can improve the early diagnosis of neonatal sepsis.