C 反应蛋白在早发型新生儿败血症中的作用 - CRP 值作为预测足月和晚期早产儿出生后早期早发型新生儿败血症的临界点？
C-reactive protein in early-onset neonatal sepsis - a cutoff point for CRP value as a predictor of early-onset neonatal sepsis in term and late preterm infants early after birth?
机构信息
Department of Neonatology, Faculty of Medicine, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
出版信息
J Matern Fetal Neonatal Med. 2022 Dec;35(23):4552-4557. doi: 10.1080/14767058.2020.1856068. Epub 2020 Dec 6.
OBJECTIVE
To identify whether the first plasma C-reactive protein values taken 6-8 h postpartum are predictive of the clinical early-onset neonatal sepsis (cEONS).
STUDY DESIGN
We retrospectively analyzed C-reactive protein (CRP) values of 400 neonates, including 28 with cEONS, who underwent plasma CRP measurements as part of sepsis work-up. To determine whether the first CRP measurement is predictive of cEONS, logistic regression was used with CRP as an independent variable and cEONS (yes/no) as a dependent variable.
RESULT
A moderate predictive ability of the first CRP measurement (odds ratio 1.4, CI: [1.13, 1.76], =.003) was revealed, at a 5.3 mg/L threshold. However, it resulted in poor sensitivity of 50%, and a false positive rate of 30%. Increasing the sensitivity to 75% or 90% lead to increased false-positive rates of 55% and 75%, respectively.
CONCLUSIONS
Our findings suggest that the first CRP value taken in neonates is a weak predictor of cEONS.
目的
确定产后 6-8 小时内首次测量的血浆 C 反应蛋白值是否可预测临床早发性新生儿败血症（cEONS）。
研究设计
我们回顾性分析了 400 名接受血浆 CRP 测量的新生儿（包括 28 名 cEONS 患儿）的 CRP 值，这些患儿均为败血症检查的一部分。为了确定首次 CRP 测量是否可预测 cEONS，我们使用逻辑回归，将 CRP 作为自变量，cEONS（是/否）作为因变量。
结果
首次 CRP 测量具有中等的预测能力（优势比 1.4，CI：[1.13, 1.76]，=0.003），截断值为 5.3mg/L。但是，其灵敏度仅为 50%，假阳性率为 30%。为了提高灵敏度至 75%或 90%，假阳性率将分别增加至 55%和 75%。
结论
我们的研究结果表明，新生儿首次 CRP 值是 cEONS 的一个弱预测指标。
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