【摘要】 目的观察降钙素原(PCT)、红细胞分度宽度(RDW)在新生儿败血症中的变化,并对其不同时间的水平进行分析。方法分析2018年10月～2020年10月收治的45例新生儿败血症的病历资料。根据新生儿危重评分分为:非危重组25例、危重组20例。从而比较PCT、RDW在不同严重程度新生儿败血症中的动态变化。结果 (1)治疗前危重组CRP及PCT水平均高于非危重组,差异有统计学意义(P均<0.05)。(2)治疗前、治疗后第1及第3日,危重组PCT均高于非危重组;两组治疗后第1日的PCT均高于治疗前、治疗后第3日,治疗后第3日的PCT均高于治疗前(P均<0.05)。治疗后第1及第3日,危重组RDW均高于非危重组;两组治疗后第1日的RDW高于治疗前、治疗后第3日,非危重组中治疗后第3日RDW低于治疗前,但危重组第3日的RDW高于治疗前(P均<0.05)。(3)不同时间点PCT与RDW对危重新生儿败血症的预测价值:治疗前、治疗后第1和第3日PCT最佳临界值分别为2.227、6.384及4.372μg/L,敏感度及特异性分别为75.0%和88.0%、95.0%和100.0%、90.0%和96.0%,ROC曲线下面积分别为0.855、0.996和0.978(P均<0.05);治疗后第1及第3日RDW最佳临界值分别为16.850%、14.900%,敏感度及特异性分别为45.0%和96.0%、65.0%和72.0%,ROC曲线下面积分别为0.688和0.732(P均<0.05)。结论对RDW、PCT水平进行动态监测有利于新生儿败血症的早期诊断,并且对新生儿败血症病情严重程度判断具有一定价值。更多还原

【Abstract】 Objective To explore the changes of PCT and RDW in neonatal sepsis, and analyze their levels at different times.Methods Analyze the medical records of 45 cases of neonatal sepsis from October 2018 to October 2020.According to the neonatal critical severity score, they were divided into: 25 non-critical recombination groups and 20 critical recombination groups.In order to compare the dynamic changes of PCT and RDW in neonatal sepsis of different severity.Results(1)The levels of CRP and PCT of critical recombination before treatment were higher than those of non-critical recombination, and the difference was statistically significant(all P<0.05).(2)Before treatment, on the 1 st and 3 rd day after treatment, the PCT of the critical group was higher than that of the non-critical group; the PCT on the first day after the treatment of the two groups were higher than the pre-treatment, the third day after the treatment, and the third day after the treatment.The daily PCT was higher than before treatment(all P<0.05).On the first and third days after treatment, the RDW of the critical group was higher than that of the non-critical group; the RDW of the two groups on the first day after treatment was higher than that of the pre-treatment and the third day after treatment, and the RDW of the non-critical group was lower on the third day after treatment Before treatment, but the RDW on the 3 rd day of critical recombination was higher than before treatment(P<0.05).(3)The predictive value of PCT and RDW at different time points for critically ill neonatal sepsis: the best cut-off values of PCT before treatment and on the first and third days after treatment are 2.227,6.384 and 4.372μg/L.Sensitivity and specificity were 75.0% and 88.0%,95.0% and 100.0%,90.0% and 96.0%,respectively.The areas under the ROC curve were 0.855,0.996 and 0.978,respectively(P<0.05);the best cut-off values of RDW on the first and third days after treatment were 16.850% and 14.900%,the sensitivity and specificity were 45.0% and 96.0%,65.0% and 72.0%,respectively, and the area under the ROC curve were 0.688 and 0.732,respectively(all P<0.05).Conclusion The dynamic monitoring of RDW and PCT levels is beneficial to the early diagnosis of neonatal sepsis and has certain value in judging the severity of neonatal sepsis.更多还原