降钙素原在新生儿感染性疾病中的临床价值

目的：探讨血清降钙素原（PCT ）在新生儿感染性疾病的临床价值。方法收集2009年3月至2012年8月新生儿科患者223例，其中败血症43例、局部感染89例、非细菌感染组59例，同时选取对照组32例。比较不同感染性疾病组间及其与对照组血清PCT浓度的差异；绘制 ROC曲线计算诊断败血症的截断值，并观察治疗前后PC T动态变化。结果非细菌感染组、局部细菌感染组和败血症组血清中 PC T 水平分别为（0．22±0．23）、（1．16±1．25）和（13．85±6．54）ng/mL ，高于健康对照组（0．22±0．29）ng/mL。局部感染组、败血症组新生儿患者血清PCT水平与白细胞计数呈正相关。以0．95 ng/mL为临界值，PCT诊断新生儿败血症的灵敏度为95．3％，特异性为93．7％。当细菌感染被控制后，血清 PC T 可以迅速回落至正常范围，动态监测结果优于白细胞。结论 PC T可作为新生儿感染性疾病早期诊断的指标，动态监测PC T水平可以观察疗效，指导临床用药。

Diagnostic value of procalcitonin for neonatal infections

Objective To explore the clinical significance of serum procalcitonin （PCT ） for neonatal infec-tions .Methods A total of 223 cases of neonatal patients ,including 43 cases of sepsis ,89 cases of local infection and 59 cases of non-bacterial infection ,treated in Department of Neonatology from March 2009 to August 2012 ,and 32 cases of healthy newborns were enrolled .Serum levels of PCT were compared between each group ,and receiver oper-ating characteristic （ROC） curve was prepared to evaluate the diagnostic value of PCT .Results Serum levels of PCT in non-bacterial infection group ,local bacterial infection group and sepsis group were （0 .22 ＆#177; 0 .23） ,（1 .16 ＆#177; 1 .25） and （13 .85 ＆#177; 6 .54） ng/mL separately ,which were all higher than the （0 .22 ＆#177; 0 .29）ng/mL of healthy control group . Serum levels of PCT in local infection group and sepsis group were positively correlated with the amount of white blood cells （WBC） .Taking 0 .95 ng/mL as cut-off value ,the sensitivity and specificity of PCT for the diagnosis of neonatal infections were 95 .3% and 93 .7% .When bacterial infections were controlled ,serum levels of PCT de-creased quickly to normal range ,which was superior to WBC .Conclusion PCT could be used as indicator for early diagnosis of neonatal infections ,and dynamic monitoring of PCT level might be helpful for evaluation of curative effect and guiding clinical medication .