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目的:评估hs-CRP与血细胞参数(WBC、GR%、PLT)在新生儿感染中的诊断价值。方法:分别检测败血症组患儿(49例),肺炎组患儿(37例)治疗前、治疗(3～5)d、治疗(7～10)d后hs-CRP、WBC、GR%、PLT各参数值,以100例健康儿为对照组。结果:治疗前,hs-CRP组间比较均有显著差异(P<0.05);WBC对照组与疾病组均有显著性差异(P<0.05),疾病组间无差异,(P>0.05);GR%败血症组与肺炎组、对照组均有差异(P<0.05),肺炎组与对照组无差异(P>0.05);PLT三组间均无显著性差异(P>0.05)。绘制疾病组各参数随治疗时间变化曲线,hs-CRP、WBC、GR%随治疗呈下降趋势,以败血症组hs-CRP表现明显,PLT随治疗呈上升趋势。应用ROC曲线求各参数对疾病诊断的敏感性、特异性、阳性预测值、阴性预测值,以败血症组hs-CRP诊断价值最高(敏感性79.6%、特异性74.0%、阳性预测值75.4%、阴性预测值78.4),败血症组WBC、GR%、PLT评估值略高于肺炎组,但敏感性、特异性、阳性预测值、阴性预测值均低于68%。结论:hs-CRP可作为新生儿败血症的早期诊断指标,但低值不能排除新生儿败血症;hs-CRP作为新生儿肺炎早期诊断指标存在一定局限性;WBC、GR%、PLT作为新生儿败血症及肺炎早期诊断指标具有局限性;hs-CRP、WBC、GR%、PLT均可应用于新生儿败血症及肺炎疗效观察中。
PURPOSE: To evaluate the diagnostic value of hs-CRP and blood cell parameters (WBC, GR%, PLT) in neonatal infection. Methods: The serum levels of hs-CRP, WBC, GR%, PLT in the septicemia group (49 cases) and the pneumonia group (37 cases) before and after treatment Each parameter value, with 100 healthy children as the control group. Results: Before treatment, there was significant difference between hs - CRP group (P <0.05). There was significant difference between WBC control group and disease group (P <0.05). There was no significant difference between the two groups (P> 0.05). There was no significant difference between the pneumonia group and the control group (P> 0.05). There was no significant difference between the PLT group and the GR% sepsis group and the pneumonia group and the control group (P <0.05). The curves of hs-CRP, WBC and GR% showed a trend of decreasing with the treatment, and the hs-CRP was obvious in sepsis group. PLT increased with the treatment. The sensitivity, specificity, positive predictive value and negative predictive value of each parameter for disease diagnosis were determined by ROC curve. The diagnostic value of hs-CRP in sepsis group was the highest (sensitivity 79.6%, specificity 74.0%, positive predictive value 75.4% Negative predictive value 78.4). The scores of WBC, GR% and PLT in sepsis group were slightly higher than those in pneumonia group, but the sensitivity, specificity, positive predictive value and negative predictive value were lower than 68%. Conclusion: hs-CRP can be used as an early diagnosis of neonatal sepsis, but low values can not rule out neonatal sepsis; hs-CRP as an early diagnosis of neonatal pneumonia markers have some limitations; WBC, GR%, PLT as neonatal sepsis and Early diagnosis of pneumothorax has limitations; hs-CRP, WBC, GR%, PLT can be used in neonatal sepsis and pneumonia efficacy.