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连续定量检测C反应蛋白和白细胞总数作为新生儿败血症的辅助诊断工具。

Serial quantification of CRP and total leukocyte count as a complementary tool in neonatal sepsis.

作者信息

Gomathi V, Chitrasivasankari G, Uma T, Saravanan M P, Gurumoorthy Kaarthikeyan

机构信息

Institute of Biochemistry, Madras Medical College, RGGGH, Chennai, India.

Institute of Biochemistry, Stanley Medical College, Chennai, India.

出版信息

Bioinformation. 2022 Oct 31;18(10):920-924. doi: 10.6026/97320630018920. eCollection 2022.

Abstract

Early detection and appropriate treatment of newborn sepsis reduce mortality and morbidity. A rapid, inexpensive laboratory approach is needed to assess newborn sepsis, even though blood culture is the gold standard for diagnosis. To compare serial CRP and Total Leukocyte Count (WBC) with blood culture, this study aimed to evaluate the role of newborn sepsis. A total 148 neonates with clinical symptoms of sepsis were included .CRP was measured by quantitative immuno turbidimetric method andotal leukocyte count (WBC) was measured by automated cell counter. CRP1 and WBC1 were measured within 6 hours of clinical symptoms. CRP2 and WBC2 were measured after 48 hours of clinical symptoms. Sensitivity, specificity, PPV, NPV of CRP1 and CRP2,WBC 1and WBC 2 were compared with culture positive and negative sepsis.CRP 2 showed high sensitivity 96% and high NPV95% with significant p value <0.0001. WBC2 has high sensitivity (90.57%) and NPV (91%) with significant p value <0.0001. CRP 1 has sensitivity 83%and NPV 82.3%, with p value < 0.001.WBC1 has lowest sensitivity (62.2%) and NPV (71.4%) compared to all other parameters. Serial CRP and WBC measurements are useful in the diagnosis of neonatal sepsis. Measurement of CRP and Total Leukocyte Count (WBC) after 48 hours of clinical symptoms were considered promptly for diagnose neonatal sepsis.

摘要

新生儿败血症的早期检测和适当治疗可降低死亡率和发病率。尽管血培养是诊断的金标准,但仍需要一种快速、廉价的实验室方法来评估新生儿败血症。为了将连续的C反应蛋白(CRP)和白细胞总数(WBC)与血培养进行比较,本研究旨在评估CRP和WBC在新生儿败血症诊断中的作用。共纳入148例有败血症临床症状的新生儿。CRP采用定量免疫比浊法测定,白细胞总数(WBC)采用自动血细胞计数器测定。CRP1和WBC1在出现临床症状后6小时内测定。CRP2和WBC2在出现临床症状48小时后测定。将CRP1、CRP2、WBC1和WBC2的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)与败血症血培养阳性和阴性结果进行比较。CRP2显示出高敏感性(96%)和高阴性预测值(95%),p值<0.0001,具有统计学意义。WBC2具有高敏感性(90.57%)和阴性预测值(91%),p值<0.0001,具有统计学意义。CRP1的敏感性为83% ,阴性预测值为82.3%,p值<0.001。与所有其他参数相比,WBC1的敏感性(62.2%)和阴性预测值(71.4%)最低。连续测定CRP和WBC有助于新生儿败血症的诊断。出现临床症状48小时后测定CRP和白细胞总数(WBC)有助于及时诊断新生儿败血症。

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