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降钙素原和 C 反应蛋白在新生儿黄疸早期鉴别诊断中的评价。

Evaluation of Procalcitonin and C-reactive Protein in Early Differential Diagnosis of Neonatal Jaundice.

出版信息

Clin Lab. 2020 Dec 1;66(12). doi: 10.7754/Clin.Lab.2020.200330.

Abstract

BACKGROUND

The purpose of this study was to investigate the clinical value of procalcitonin (PCT) and C-reactive protein (CRP) in the differential diagnosis of neonatal jaundice.

METHODS

Eighty-five cases of neonatal jaundice in our hospital from January 2016 to March 2019 were selected as research subjects, including 30 cases of physiological jaundice, 23 cases of infectious jaundice, and 32 cases of he-molytic jaundice. Five milliliters of non-anticoagulated venous peripheral blood and 3 mL EDTA-K+ anticoagulated venous peripheral blood were sampled from each newborn when the symptoms of jaundice occurred. The non-anticoagulated blood samples were then centrifuged at 3,500 rpm for 7 minutes and the serum was used for PCT and bilirubin examinations, and the anticoagulated blood samples were prepared for CRP examination. Receiver operating characteristic (ROC) curve analysis was performed for the evaluation of differential diagnosis of neonatal jaundice by PCT, CRP, and bilirubin levels.

RESULTS

Analyses of variance showed the postnatal age of jaundice occurring in the physiological jaundice group was older than those in the infectious jaundice and hemolytic jaundice groups (p < 0.001), and the PCT and CRP levels in the infectious jaundice group were higher than those in the hemolytic jaundice and physiological jaundice groups (p < 0.001). Pearson's correlation analysis indicated that the levels of PCT and CRP were negatively correlated with postnatal age in the physiological jaundice group (p < 0.05). ROC curve analysis demonstrated that PCT and CRP had the highest differential diagnosis efficacy of neonatal pathological and neonatal physiological jaundice with PCT and CRP at 0.70 µg/L and 8.50 mg/L, respectively, as well as the highest differential diagnosis efficacy of neonatal infectious jaundice and neonatal hemolytic jaundice with PCT and CRP at 1.84 µg/L and 13.50 mg/L, respectively.

CONCLUSIONS

This study suggested that PCT and CRP possessed important clinical values in the differential diagnosis of neonatal jaundice, and PCT was superior to the differential diagnosis of neonatal infectious jaundice.

摘要

背景

本研究旨在探讨降钙素原(PCT)和 C 反应蛋白(CRP)在新生儿黄疸鉴别诊断中的临床价值。

方法

选取 2016 年 1 月至 2019 年 3 月我院收治的新生儿黄疸 85 例为研究对象,其中生理性黄疸 30 例、感染性黄疸 23 例、溶血性黄疸 32 例。新生儿出现黄疸症状时,采集其 5ml 非抗凝静脉外周血和 3ml EDTA-K+抗凝静脉外周血,非抗凝血标本以 3500rpm 离心 7min,分离血清检测 PCT 和胆红素,抗凝血标本用于 CRP 检测。采用受试者工作特征(ROC)曲线分析 PCT、CRP 和胆红素水平对新生儿黄疸的鉴别诊断价值。

结果

方差分析显示,生理性黄疸组黄疸出现的胎龄大于感染性黄疸组和溶血性黄疸组(p<0.001),感染性黄疸组 PCT 和 CRP 水平高于溶血性黄疸组和生理性黄疸组(p<0.001)。Pearson 相关分析显示,生理性黄疸组 PCT 和 CRP 水平与胎龄呈负相关(p<0.05)。ROC 曲线分析显示,PCT 和 CRP 对新生儿病理性黄疸和新生儿生理性黄疸的鉴别诊断效能最高,截断值分别为 0.70μg/L 和 8.50mg/L;对新生儿感染性黄疸和新生儿溶血性黄疸的鉴别诊断效能最高,截断值分别为 1.84μg/L 和 13.50mg/L。

结论

本研究表明 PCT 和 CRP 在新生儿黄疸鉴别诊断中具有重要的临床价值,且 PCT 对新生儿感染性黄疸的鉴别诊断效能优于 CRP。

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