Distefano G, Curreri R, Betta P, Romeo M G, Amato M
Department of Pediatrics, University of Catania, Italy.
Acta Paediatr. 2004 Feb;93(2):216-9.
To determine reference values for procalcitonin (PCT) and C-reactive protein (CRP) for gestational age and to use these parameters as diagnostic markers of perinatal bacterial and fungal infection.
PCT and CRP serum levels were measured in a case-control study in a group of 35 low birthweight infants (< 34 wk of gestation). 27 babies (77%) had clinical signs of infection confirmed by positive blood cultures and were compared to 8 (23%) uninfected matched patients. Seventeen (63%) of them had bacterial infection and 10 (37%) had fungal infection (Candida). Serum PCT (Brahms Diagnostika) and CRP (Immunoassay Vitros 950) were measured serially at 3, 7 and 10d of life.
At any time, PCT and CRP levels were significantly higher in neonates with perinatal infection (p < 0.05) (> 0.7 ng ml(-1) and > 1 mg dl(-1) respectively). PCT showed a more rapid response to infection (9.3 +/- 1.5 ng ml(-1)). especially to bacterial infection (10.8 +/- 1.4 ng ml(-1)), than CRP (1.5 +/- 0.5 mg dl(-1)) (sensitivity 99% vs 88%). Lower sensitivity was noted for both parameters. PCT and CRP, to follow babies with fungal infection (6.7 +/- 0.8 ng ml(-1) and 0.9 +/- 0.7 mg dl(-1), respectively) (sensitivity 77% vs 58%).
This study gives PCT reference values in preterm babies with perinatal infection. In these babies, PCT seems to be more sensitive than CRP as a diagnostic marker of infection. Both parameters can be used alone or in combination for a better identification and follow-up of bacterial and fungal infection during the perinatal period.
确定胎龄相关的降钙素原（PCT）和C反应蛋白（CRP）参考值，并将这些参数用作围产期细菌和真菌感染的诊断标志物。
在一项病例对照研究中，对一组35例低出生体重儿（胎龄<34周）测量PCT和CRP血清水平。27例婴儿（77%）有经血培养阳性证实的感染临床体征，并与8例（23%）未感染的匹配患者进行比较。其中17例（63%）有细菌感染，10例（37%）有真菌感染（念珠菌）。在出生后第3、7和10天连续测量血清PCT（Brahms诊断试剂）和CRP（免疫分析Vitros 950）。
在任何时间，围产期感染新生儿的PCT和CRP水平均显著更高（p<0.05）（分别>0.7 ng/ml和>1 mg/dl）。PCT对感染，尤其是对细菌感染（10.8±1.4 ng/ml）的反应比CRP（1.5±0.5 mg/dl）更快（敏感性分别为99%和88%）。这两个参数对真菌感染婴儿的敏感性较低（PCT和CRP分别为6.7±0.8 ng/ml和0.9±0.7 mg/dl）（敏感性分别为77%和58%）。
本研究给出了围产期感染早产儿的PCT参考值。在这些婴儿中，PCT作为感染诊断标志物似乎比CRP更敏感。这两个参数可单独或联合使用，以更好地识别和随访围产期细菌和真菌感染。
