摘要
探讨SAA(serum amyloid A)、CRP(C reactive protein)、PCT(procalcitonic)、WBC(white blood cell)及N%(neutrophil%)在新生儿败血症诊断中的应用价值。采用回顾性研究,选取南华大学附属长沙中心医院新生儿科2022年1月至2024年1月收治的173例临床诊断败血症患儿、66例确定诊断败血症患儿分别作为病例组,同期住院的新生儿黄疸患儿148例为对照组。患儿入院后24 h内采集空腹静脉血检测血清WBC、N%、SAA、CRP及PCT水平。采用单因素方差分析、Kruskal-WallisH检验比较三组患儿的一般资料、炎性指标水平;SAA与其他炎性指标相关性分析采用Spearman相关分析;采用受试者工作特征(receiver operating characteristic,ROC)曲线判断不同炎症指标对新生儿确定诊断败血症组与临床诊断败血症组的诊断效能。结果显示临床诊断败血症组WBC[(16.88±5.64)×10^(9)/L]、N%[70.00(63.00,75.00)]、PCT[2.22(1.20,5.55)mg/L]、CRP[3.00(0.50,10.30)mg/L]、SAA[19.70(10.82,49.90)mg/L]和确定诊断败血症组WBC[(16.10±7.48)×10^(9)/L]、N%[73.50(61.50,80.93)]、PCT[5.35(0.69,20.07)mg/L]、CRP[15.52(4.98,30.50)mg/L]、SAA[43.95(14.00,175.98)mg/L]均高于对照组(11.17±3.38)×10^(9)/L、49.81(36.93,62.75)、0.20(0.07,0.99)mg/L、0.54(0.20,1.40)mg/L、5.15(3.60,8.68)mg/L,差异均有统计学意义(均P<0.05);Spearman相关分析显示,SAA水平与WBC、N%、PCT、CRP均呈正相关(rs=0.453、0.540、0.343、0.550,均P<0.05);ROC曲线分析显示,SAA对确定诊断败血症组和临床诊断败血症组ROC曲线下面积(area under ROC curve,AUC)均高于其他炎性指标。其中,SAA诊断确诊新生儿败血症组的AUC为0.933(95%CI:0.809~1.000,P<0.05),敏感度为92.90%、特异度为99.30%;SAA对诊断临床诊断败血症组的AUC为0.861(95%CI:0.818~0.904,P<0.05),敏感度为83.20%、特异度为81.80%。综上,相比CRP、PCT、WBC和N%,SAA对区分新生儿败血症(包括确诊败血症和临床诊断败血症)具有较高的敏感度和特异度,对新生儿败�
To explore the application value of SAA(serum amyloid A),CRP(C reactive protein),PCT(procalcitonin),WBC(white blood cell)and N%(neutrophil%)in the diagnosis of neonatal septicemia.This study was a retrospective study.173 children with clinically diagnosed septicemia and 66 children with definitely diagnosed septicemia admitted to the Department of Neonatology,the Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China,from January 2022 to January 2024 were selected as the case group,and 148 children with neonatal jaundice who were hospitalized during the same period were selected as the control group.Fasting venous blood was collected within 24 hours after the children′s admission to detect the levels of serum WBC,N%,SAA,CRP and PCT.One-way analysis of variance and Kruskal-Wallis H test were used to compare the general data and inflammatory index levels of the three groups of children.The correlation analysis between SAA and other inflammatory indicators was conducted using Spearman correlation analysis.The receiver operating characteristic(ROC)curve was used to determine the diagnostic efficacy of different inflammatory indicators for patients with definitely diagnosed septicemia and those with clinically diagnosed septicemia,and for those with clinically diagnosed septicemia and those without infection.The results showed that the levels of WBC[(16.88±5.64)×10^(9)/L],N%[70.00(63.00,75.00)],PCT[2.22(1.20,5.55)mg/L],CRP[3.00(0.50,10.30)mg/L],SAA[19.70(10.82,49.90)mg/L]in the clinically diagnosed septicemia group and WBC[(16.10±7.48)×10^(9)/L],N%[73.50(61.50,80.93)],PCT[5.35(0.69,20.07)mg/L],CRP[15.52(4.98,30.50)mg/L],SAA[43.95(14.00,175.98)mg/L]in the definitely diagnosed septicemia group were all higher than those in the control group(11.17±3.38)×10^(9)/L,49.81(36.93,62.75),0.20(0.07,0.99)mg/L,0.54(0.20,1.40)mg/L,5.15(3.60,8.68)mg/L,and the differences were all statistically significant(all P<0.05).Spearman correlation analysis showed that the level of SAA was positively cor
作者
杨琴
方佳
许莹
杨艳
严湘红
Yang Qin;Fang Jia;Xu Ying;Yang Yan;Yan Xianghong(Department of Neonatology,The Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China,Changsha 410004,China;Department of Blood Transfusion,The Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China,Changsha 410004,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2024年第10期1587-1592,共6页
Chinese Journal of Preventive Medicine
基金
湖南省自然科学基金项目(2024JJ9501)。
