Waliullah S M, Islam M N, Siddika M, Hossain M A, Jahan I, Chowdhury A K
Department of Neonatology, Chittagong Medical College, Chittagong, Bangladesh.
Mymensingh Med J. 2010 Jan;19(1):41-7.
This prospective study was undertaken in Dhaka Shishu Hospital from 15th March 2005 to 15th October 2006 to evaluate the role of simple hematological test for early diagnosis of neonatal sepsis. Eighty suspected cases of septicaemia admitted in neonatal ward of Dhaka Shishu Hospital were included in this study. Patients those who had history of perinatal asphyxia, infant of diabetic mother, congenital cyanotic heart disease etc. were excluded from the study. Thirty neonates without sign symptoms of septicaemia admitted for other causes like jaundice, feeding problems etc. were taken as a control group. After taking informed consent data were collected in structured questionnaire. Following laboratory investigations like total WBC count, differential count, absolute neutrophil count, band cell count, platelet count, CRP, blood culture were done. Micro-ESR was done as bed side test. Immature and total neutrophil ratio (I/T ratio) detected from total neutrophil and band form count. Patients with positive blood culture were categorized as definite sepsis. Patients with negative blood culture but abnormal hematological report suggestive of sepsis were categorized as probable sepsis. Those who had no signs of sepsis were categorized as control group. Absolute neutrophil count (ANC) had low sensitivity (13%) but Micro-ESR, CRP, I/T ratio, platelet count had moderately high sensitivity and specificity. These simple hematological screen are useful marker for early diagnosis of neonatal sepsis.
这项前瞻性研究于2005年3月15日至2006年10月15日在达卡儿童医院进行，以评估简单血液学检查在新生儿败血症早期诊断中的作用。本研究纳入了达卡儿童医院新生儿病房收治的80例疑似败血症病例。有围产期窒息史、糖尿病母亲婴儿、先天性青紫型心脏病等病史的患者被排除在研究之外。选取30例因黄疸、喂养问题等其他原因入院且无败血症体征症状的新生儿作为对照组。在获得知情同意后，通过结构化问卷收集数据。进行了以下实验室检查，如白细胞总数、分类计数、绝对中性粒细胞计数、杆状核细胞计数、血小板计数、CRP、血培养。微量血沉率作为床边检查进行。根据中性粒细胞总数和杆状核细胞计数检测未成熟与总中性粒细胞比率（I/T比率）。血培养阳性的患者归类为确诊败血症。血培养阴性但血液学报告异常提示败血症的患者归类为可能败血症。无败血症体征的患者归类为对照组。绝对中性粒细胞计数（ANC）敏感性较低（13%），但微量血沉率、CRP、I/T比率、血小板计数具有中等偏高的敏感性和特异性。这些简单的血液学筛查是新生儿败血症早期诊断的有用标志物。
