Kawczyński Paweł, Piotrowski Andrzej
Oddział Neonatologii Kliniki Perinatologii Instytutu Ginekologii i Połoznictwa w Lodzi.
Ginekol Pol. 2004 Jun;75(6):439-44.
Sensitive, reliable and early parameters of bacterial infection are extremely valuable in diagnosis of nosocomial infections in neonatal intensive care unit. In this study procalcitonin (PCT) and C-reactive protein (CRP) were evaluated for their diagnostic relevance in neonatal late onset sepsis.
Clinical study
We analysed inflammatory parameters in 48 newborn infants admitted to the Intensive Care Unit of Institute of Paediatrics in Lodz who suffered from nosocomial sepsis. They were sampled for PCT and CRP levels at the time of the onset of signs and 24 hours later. CRP was determined by an nephelometric method and PCT was determined by an immunoluminometric assay.
At the onset of Gram negative sepsis 14 from 17 contaminated newborns had significantly increased CRP levels and 15 of them had increased levels of PCT After 24 hours 100% of them had elevated PCT and CRP levels. At the onset of Gram positive sepsis only 18 from 31 neonates with positive blood culture had increased CRP levels and 28 of them had elevated concentrations of PCT. This difference was statistically significant. After 24 hours 26 of them had elevated CRP and 100% had increased PCT concentrations--this difference was not significant.
Measurement of procalcitonin concentrations may be useful for early diagnosis of late onset sepsis in neonates.
敏感、可靠且早期的细菌感染指标对于新生儿重症监护病房医院感染的诊断极为重要。本研究评估了降钙素原（PCT）和C反应蛋白（CRP）在新生儿晚发性败血症诊断中的相关性。
临床研究
我们分析了48名入住罗兹儿科研究所重症监护病房且患有医院感染败血症的新生儿的炎症指标。在症状出现时及24小时后采集他们的PCT和CRP水平样本。CRP通过散射比浊法测定，PCT通过免疫发光测定法测定。
在革兰阴性败血症发作时，17名受感染新生儿中有14名CRP水平显著升高，其中15名PCT水平升高。24小时后，他们的PCT和CRP水平均100%升高。在革兰阳性败血症发作时，31名血培养阳性的新生儿中只有18名CRP水平升高，其中28名PCT浓度升高。这种差异具有统计学意义。24小时后，其中26名CRP升高，100%的PCT浓度升高——这种差异不显著。
降钙素原浓度的测定可能有助于新生儿晚发性败血症的早期诊断。
