降钙素原作为极低出生体重早产儿晚发性败血症的筛查试验。

Procalcitonin as a screening test for late-onset sepsis in preterm very low birth weight infants.

作者信息

Vazzalwar Ramesh, Pina-Rodrigues Estela, Puppala Bhagya L, Angst Denise B, Schweig Lorene

机构信息

Division of Neonatology, Department of Pediatrics, Advocate Lutheran General Children's Hospital, Park Ridge, IL 60068, USA.

出版信息

J Perinatol. 2005 Jun;25(6):397-402. doi: 10.1038/sj.jp.7211296.

DOI:10.1038/sj.jp.7211296

PMID:15830005

Abstract

OBJECTIVE

To compare the utility of procalcitonin (PCT) vs C-reactive protein (CRP) as indicators of late-onset neonatal sepsis in very low birth weight (VLBW) infants.

METHODS

PCT and CRP levels were measured in VLBW infants with suspected sepsis and controls. Comparisons were made between infected vs noninfected infants. Using cutoff values of 0.5 and 1.0 ng/ml for PCT and 0.8 mg/dl for CRP, sensitivity, specificity, positive and negative predictive values were calculated to evaluate these assays as potential predictors of late-onset sepsis.

RESULTS

A total of 67 infants were evaluated. Mean PCT levels were significantly higher in the infected group (5.41 ng/ml) compared to the noninfected group (0.43 ng/ml) (p < 0.001). At a cut off value of 0.5 ng/ml, the sensitivity of PCT was 97%, whereas that of CRP was 73% in predicting late-onset sepsis. At a PCT cutoff of 1.0 ng/ml, sensitivities of PCT and CRP were similar (72% each).

CONCLUSION

PCT (0.5 ng/ml) is more sensitive than CRP in predicting late-onset sepsis in VLBW infants.

摘要

目的

比较降钙素原（PCT）与C反应蛋白（CRP）作为极低出生体重（VLBW）婴儿晚发性新生儿败血症指标的效用。

方法

对疑似败血症的VLBW婴儿和对照组婴儿测量PCT和CRP水平。对感染婴儿与未感染婴儿进行比较。使用PCT的临界值0.5和1.0 ng/ml以及CRP的临界值0.8 mg/dl，计算敏感性、特异性、阳性和阴性预测值，以评估这些检测作为晚发性败血症潜在预测指标的效能。

结果

共评估了67名婴儿。感染组的平均PCT水平（5.41 ng/ml）显著高于未感染组（0.43 ng/ml）（p < 0.001）。在临界值为0.5 ng/ml时，PCT预测晚发性败血症的敏感性为97%，而CRP为73%。在PCT临界值为1.0 ng/ml时，PCT和CRP的敏感性相似（均为72%）。