Pérez Solís D, López Sastre J B, Coto Cotallo G D, Diéguez Junquera María A, Deschamps Mosquera E María, Crespo Hernández M
Departamento de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Spain.
An Pediatr (Barc). 2006 Apr;64(4):341-8. doi: 10.1157/13086522.
To evaluate procalcitonin (PCT) as a diagnostic marker of neonatal sepsis of vertical transmission and to compare the results of PCT with those of the most widely used laboratory tests for sepsis.
A prospective study was conducted in 136 blood samples from 69 newborn infants admitted to a neonatal department. PCT, C-reactive protein (CRP), leukocyte count, and the immature-to-total neutrophil ratio (I/T ratio) were measured. The PCT reference range of controls from 0 to 72 hours of life was constructed, and the diagnostic efficiency of the tests was calculated, with their 95 % confidence intervals (95 % CI).
This study included 35 controls, 24 neonates with noninfectious disorders, and 10 neonates with sepsis (5 with culture-proven sepsis). PCT, CRP, and the I/T ratio discriminated septic from nonseptic patients. Their areas under the ROC curve were 0.696 (p = 0.009), 0.735 (p = 0.002), and 0.703 (p = 0.006), respectively, with no statistically significant differences. The accuracy of PCT, CRP, and leukocyte count improved after 24 hours of life with areas under the ROC curve of 0.813 (p = 0.007), 0.826 (p = 0.005), and 0.841 (p = 0.003), respectively. Overall, PCT detected vertically transmitted sepsis with a sensitivity of 68.4 % (95 % CI: 46.0 %-84.6 %), specificity of 82.4 % (95 % CI: 72.2 %-89.4 %), positive likelihood ratio of 3.89 (95 % CI: 2.18 %-6.96 %), and negative likelihood ratio of 0.38 (95 % CI: 0.19 %-0.76 %), similar to those of CRP.
PCT may be a useful marker for the diagnosis of vertically transmitted sepsis. Studies with larger sample sizes are required to establish the accuracy of PCT.
评估降钙素原（PCT）作为垂直传播新生儿败血症的诊断标志物，并将PCT的检测结果与败血症最常用的实验室检测结果进行比较。
对新生儿科收治的69例新生儿的136份血样进行了一项前瞻性研究。检测了PCT、C反应蛋白（CRP）、白细胞计数和未成熟中性粒细胞与总中性粒细胞比值（I/T比值）。构建了出生后0至72小时对照组的PCT参考范围，并计算了各项检测的诊断效率及其95%置信区间（95%CI）。
本研究纳入35例对照组、24例患有非感染性疾病的新生儿和10例患有败血症的新生儿（5例血培养证实为败血症）。PCT、CRP和I/T比值可区分败血症患儿与非败血症患儿。它们的ROC曲线下面积分别为0.696（p = 0.009）、0.735（p = 0.002）和0.703（p = 0.006），无统计学显著差异。出生24小时后，PCT、CRP和白细胞计数的准确性有所提高，ROC曲线下面积分别为0.813（p = 0.007）、0.826（p = 0.005）和0.841（p = 0.003）。总体而言，PCT检测垂直传播败血症的敏感性为68.4%（95%CI：46.0%-84.6%），特异性为82.4%（95%CI：72.2%-89.4%），阳性似然比为3.89（95%CI：2.18%-6.96%）,阴性似然比为0.38（95%CI：0.19%-0.76%），与CRP相似。
PCT可能是诊断垂直传播败血症的有用标志物。需要进行更大样本量的研究来确定PCT的准确性。
