C反应蛋白（CRP）在新生儿败血症诊断中的有效性。
Validity of C-reactive protein (CRP) for diagnosis of neonatal sepsis.
作者信息
Hisamuddin Effat, Hisam Aliya, Wahid Sughra, Raza Ghulam
机构信息
Effat Hisamuddin, MBBS, FCPS (Paeds), Consultant Paediatrician, Tehsil Headquarter Hospital (THQ), Chakdara, Khyber Pakhtunkhwa, Pakistan.
Aliya Hisam, MBBS, MPH, Assistant Professor, Community Medicine Department, National University of Sciences and Technology (NUST), Army Medical College, Rawalpindi, Pakistan.
出版信息
Pak J Med Sci. 2015;31(3):527-31. doi: 10.12669/pjms.313.6668.
OBJECTIVE
To determine the validity of C-reactive protein levels for diagnosis of neonatal sepsis.
METHODS
A cross sectional (Validation) study was conducted at Neonatology unit in KRL general hospital (emergency/OPD) of 7 months duration from February 2012 to August 2012. By using purposive sampling technique, 147, sample size was calculated by using WHO sample size calculator taking sensitivity 75%, specificity 95%, expected prevalence 50%, desired precision 10% and confidence level 95%.
RESULTS
Mean age of the neonates was 5.72 days + 3.86. Male patients were 81(55.1%) while 66(44.9%) were female. Neonatal sepsis was observed in 43(29.25%) and were confirmed through blood culture while 104(70.75%) were not confirmed on blood culture as neonatal sepsis. The sensitivity and specificity of CRP in diagnosis of acute neonatal sepsis was 76.92% and 53.49% respectively while it had a positive predictive value of 80% and negative predictive value of 48.94%. Over all the diagnostic accuracy of CRP in diagnosis of neonatal sepsis was 70.07%.
CONCLUSION
CRP estimation does have a role in the diagnosis of neonatal sepsis but the test is not specific enough to be relied upon as the only indicator.
目的
确定C反应蛋白水平对新生儿败血症诊断的有效性。
方法
于2012年2月至2012年8月在KRL综合医院新生儿科（急诊/门诊）进行了一项为期7个月的横断面（验证）研究。采用立意抽样技术，通过世界卫生组织样本量计算器计算样本量，设定灵敏度为75%、特异度为95%、预期患病率为50%、期望精度为10%、置信水平为95%。
结果
新生儿的平均年龄为5.72天±3.86天。男性患者81例（55.1%），女性患者66例（44.9%）。观察到43例（29.25%）新生儿败血症，通过血培养确诊，而104例（70.75%）血培养未确诊为新生儿败血症。CRP诊断急性新生儿败血症的灵敏度和特异度分别为76.92%和53.49%，阳性预测值为80%，阴性预测值为4...94%。总体而言，CRP诊断新生儿败血症的诊断准确性为70.07%。
结论
CRP测定在新生儿败血症诊断中确实有作用，但该检测不够特异，不能仅作为唯一指标依赖。
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