Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China.
Department of Anorectal Surgery, Zhengzhou Hospital Affiliated to Jinan University, Zhengzhou, China.
Mediators Inflamm. 2022 Jul 14;2022:4711018. doi: 10.1155/2022/4711018. eCollection 2022.
Neonates with pneumonia often also have sepsis, and the identifying sepsis from pneumonia may be a challenge for clinicians. However, there are no available data regarding the clinical value C-reactive protein-to-albumin ratio (CAR) in identifying sepsis in neonates with pneumonia. The aim of this study was to evaluate the clinical value of CAR in identifying sepsis in neonates with pneumonia.
847 neonates with pneumonia were included in this study, of which 511 neonates were diagnosed with sepsis. Neonates were divided into the sepsis group and the nonsepsis group. All neonates underwent extensive and necessary clinical and laboratory tests. CAR was calculated as serum C-reactive protein (ng/ml)/albumin (mg/ml). All statistical analyses were performed using the statistical package SPSS 24.0, as appropriate.
Compared with the nonsepsis group, neonates with sepsis have a higher CAR ( < 0.001). Further analysis showed that the prevalence of neonates with sepsis increased significantly from 41.0% in the low CAR group (CAR ≤ 0.024 × 10) to 80.0% in the high CAR group (CAR > 0.024 × 10) ( < 0.001). Correlation analysis showed that there was a strong positive correlation between CAR and PCT ( = 0.452, < 0.001), nSOFA ( = 0.267, < 0.001), and the prolonged length of hospital stay ( = 0.311, < 0.001). Multiple logistic regression showed that CAR was an independent risk factor for the presence of sepsis in neonates with pneumonia. Receiver operating characteristic curve analysis revealed that CAR had adequate discriminatory power in predicting sepsis in neonates with pneumonia (area under curve (AUC) = 0.76, 95% CI 0.73-0.79, < 0.001).
CAR can be used as a new marker to identify sepsis in neonates with pneumonia.
患有肺炎的新生儿通常也患有败血症，因此临床医生可能难以将败血症与肺炎区分开来。然而，目前尚无关于 C 反应蛋白与白蛋白比值（CAR）在识别患有肺炎的新生儿败血症方面的临床价值的可用数据。本研究旨在评估 CAR 在识别患有肺炎的新生儿败血症方面的临床价值。
本研究纳入了 847 名患有肺炎的新生儿，其中 511 名新生儿被诊断为败血症。新生儿被分为败血症组和非败血症组。所有新生儿均接受了广泛而必要的临床和实验室检查。CAR 计算方法为血清 C 反应蛋白（ng/ml）/白蛋白（mg/ml）。所有统计分析均使用适当的统计软件包 SPSS 24.0 进行。
与非败血症组相比，败血症组的 CAR 更高（<0.001）。进一步分析显示，败血症患儿的患病率从低 CAR 组（CAR ≤ 0.024×10）的 41.0%显著升高到高 CAR 组（CAR > 0.024×10）的 80.0%（<0.001）。相关性分析表明，CAR 与 PCT（=0.452，<0.001）、nSOFA（=0.267，<0.001）和延长的住院时间（=0.311，<0.001）呈强正相关。多因素逻辑回归分析表明，CAR 是肺炎新生儿败血症存在的独立危险因素。受试者工作特征曲线分析显示，CAR 对肺炎新生儿败血症具有良好的预测能力（曲线下面积（AUC）=0.76，95%置信区间 0.73-0.79，<0.001）。
CAR 可作为一种新的标志物，用于识别患有肺炎的新生儿败血症。
