超敏C-反应蛋白测定在早产儿早发感染诊断中的意义

Hypersensitive C-reactive protein test in the diagnosis of early-onset infection in premature infants

摘要:

目的：通过超敏法检测早产儿出生早期血清C-反应蛋白(hsCRP)水平，评价该指标在早产儿早发感染早期诊断中的临床价值。方法：以出生3 h内转入该院的早发感染早产儿35例、非感染性疾病早产儿50例和无合并症的单纯早产儿40例为研究对象，应用微粒子增强透射免疫分析法进行血清hsCRP水平检测，并通过诊断试验评价其临床应用价值。结果：早产儿血清hsCRP水平以中位数和四分位间距表示（M，Q75-25），早发感染组为2.19、4.96 mg/L；非感染性疾病组为0.41、0.61 mg/L；单纯早产儿组为0.24、0.28 mg/L。早发感染组血清hsCRP水平明显高于其他两组。通过血清hsCRP测定对早产儿早发感染进行诊断，ROC曲线下面积为0.84，95%可信区间为(0.76，0.93)；诊断敏感度为74%，特异度为86%；阳性预测值为37%，阴性预测值为97%。结论：测定血清hsCRP在早产儿早发感染的早期诊断中具有一定的临床应用价值，但不能作为独立的诊断指标。［中国当代儿科杂志，2009，11（10）：813-816］

Abstract:

OBJECTIVE: To evaluate the clinical value of serum hypersensitive C-reactive protein (hsCRP) test in early diagnosis of early-onset infection in premature infants. METHODS: Thirty-five premature infants with early-onset infection, 50 premature infants with non-infectious diseases and 40 healthy premature infants 3 hrs after birth were enrolled. Serum hsCRP levels were measured by particle enhanced immunoturbidimetric assay. Diagnostic test of hsCRP was performed. RESULTS: Serum hsCRP levels shown as medium and inter-quartile ranges (M, Q75-25) were 2.19 and 4.96 mg/L respectively in the infection group, 0.41 and 0.61 mg/L respectively in the non-infectious disease group, and 0.24 and 0.28 mg/L respectively in the healthy group. Serum hsCRP levels in the infection group were significantly higher than those in the non-infectious disease and the healthy groups. When serum hsCRP test was used for the diagnosis of early-onset infection, the area under the ROC curve was 0.84, 95% confidence interval was 0.76-0.93, the diagnostic sensitivity and specificity were 74% and 86% respectively, and the positive and negative predictive values were 37% and 97% respectively. ConclusionsSerum hsCRP test is valuable in early diagnosis of early-onset infection in premature infants, but it can not serve as an independent diagnostic marker.［Chin J Contemp Pediatr, 2009, 11 (10):813-816］