Rusia Usha, Sikka Meera, Faridi M M A, Madan Nishi
Department of Pathology, University College of Medical Sciences & G.T.B Hospital, Shahdra, Delhi.
Indian J Pathol Microbiol. 2003 Oct;46(4):565-8.
This study was designed to evaluate the utility of hematological parameters and C-reactive protein (CRP) to formulate a sepsis screen to detect sepsis in early and late onset infection. Hundred and fifty neonates clinically suspected of bacterial infection, based on risk factors and/or clinical features were selected for the study. Blood was collected by venipuncture at the time of admission in all neonates. A total leukocyte count (TLC), differential leukocyte count (DLC), its derivatives [Total neutrophil count (TNC or T), ratio of immature to total neutrophil count (I/T), ratio of immature to mature neutrophil count (I/M)] and CRP were obtained. TLC = 10x10(9)/L, TNC = 8x10(9)/L, I/T = 0.16, I/M = 0.25 and CRP = 0.6 mg/dl were found to be good parameters in detection of sepsis. During the first three days of life leukopenia, neutropenia, elevated I/T ratio, elevated I/M ratio and CRP were good diagnostic aids while after 3 days of life CRP was the best single test. This emphasizes use of multiple indicators for detection of sepsis. Using these parameters a sepsis screen was formulated which detected >90% of proven early and late onset sepsis suggesting that other neonates with positive sepsis screen but blood culture negativity may have been truly infected.
本研究旨在评估血液学参数和C反应蛋白（CRP）在制定脓毒症筛查方法以检测早发型和晚发型感染中的脓毒症方面的效用。基于风险因素和/或临床特征，选择了150例临床怀疑有细菌感染的新生儿进行研究。所有新生儿在入院时通过静脉穿刺采集血液。获得了总白细胞计数（TLC）、白细胞分类计数（DLC）及其衍生指标[总中性粒细胞计数（TNC或T）、未成熟中性粒细胞与总中性粒细胞计数之比（I/T）、未成熟中性粒细胞与成熟中性粒细胞计数之比（I/M）]以及CRP。发现TLC = 10×10⁹/L、TNC = 8×10⁹/L、I/T = 0.16、I/M = 0.25以及CRP = 0.6mg/dl是检测脓毒症的良好参数。在出生后的头三天，白细胞减少、中性粒细胞减少、I/T比值升高、I/M比值升高以及CRP是良好的诊断辅助指标，而在出生三天后，CRP是最佳的单项检测指标。这强调了使用多种指标来检测脓毒症。利用这些参数制定了一个脓毒症筛查方法，该方法检测出>90%已证实的早发型和晚发型脓毒症，这表明其他脓毒症筛查呈阳性但血培养阴性的新生儿可能确实受到了感染。
