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目的探讨脐血降钙素原(PCT)、全程C-反应蛋白(CRP)和白介素-6(IL-6)水平检测在新生儿宫内感染早期诊断中的价值。方法选择2015年8月-2016年8月在吉林省妇幼保健院分娩,有宫内感染高危因素的163例新生儿为研究对象,根据结局分为感染组和无感染组,其中感染组20例,无感染组143例,比较两组脐血炎性指标水平及阳性率、敏感度、特异度、阳性似然比及阴性似然比。结果感染组脐带血的三项炎性指标检测值及阳性率均显著高于无感染组(P<0.01);感染组PCT、IL-6及联合检测的各指标阳性率均显著高于全程CRP的阳性率(P<0.01);感染组的PCT联合IL-6检测指标阳性率最高,为95.0%,特异度为88.1%,阴性似然比最低。结论脐血PCT和IL-6可作为宫内感染早期诊断的有效炎性指标,而脐血PCT联合IL-6联合检测可进一步提高诊断的敏感度。
Objective To investigate the diagnostic value of cord blood procalcitonin (PCT), full C-reactive protein (CRP) and interleukin-6 (IL-6) in the early diagnosis of neonatal intrauterine infection. Methods A total of 163 newborns with high risk of intrauterine infection who were delivered at Jilin Provincial Maternal and Child Health Hospital from August 2015 to August 2016 were divided into infected group and non-infected group according to the outcome. Among them, 20 , 143 cases without infection group. The cord blood inflammatory index level, positive rate, sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were compared between the two groups. Results The positive rate of the three inflammatory markers in the cord blood of the infected group were significantly higher than those in the non-infected group (P <0.01). The positive rates of PCT, IL-6 and the combined detection of the infected group were significantly higher than those of the whole CRP (P <0.01). The positive rate of PCT combined with IL-6 in the infected group was the highest (95.0%), the specificity was 88.1%, and the negative likelihood ratio was the lowest. Conclusion Umbilical cord blood PCT and IL-6 can be used as an effective inflammatory marker for early diagnosis of intrauterine infection, and combined cord blood PCT and IL-6 detection can further improve the diagnostic sensitivity.