The Expression And Significance Of Procalcitonin In Neonatal Infection

ObjectiveThis study is aimed to investigate the serum procalcitonin (procalcitonin PCT) in neonatal infection changes and its clinical significance by the ELFA (enzyme-linked fluorescent analysis) and comparison to the C-reactive protein (C-of reactive protein, CRP).Materials and methods1. The study covers the newborn babies whose inpatient days are less than28days from August1,2011to April30,2012in the Department of Pediatrics in Xiangtan Central Hospital of Hunan Province. They are divided into systemic infection, local infection group and non-infected group according to the site and extent of infection. According to the severity of illness, it studies the critically ill patients from the group of systemic infection and local infection to discover PCT level dynamic changes of the objects. All of the subjects exclude patients with antibiotics before admission,born with severe asphyxia and multiple organ dysfunction, mothers with children with serious pregnancy complications.2. Sample collection:Taking the radial arterial blood study within two hours of admission (blood drawn will be done after48hours on the the ones are<48hours after birth) Draw Radial artery blood4ml to improve the PCT, C-reactive protein (C-of reactive protein, CRP), blood tests. To the critically ill children, on the4th days and7th days after the1st blood drawn more4ml needed to be drawn to review routine blood test, CRP and the PCT. All subjects admitted to hospital need to draw blood2ml before using antibiotics to improve conventional blood culture examination. Respiratory tract infection in neonates remain sputum liquid to do the relevant checks. Local skin and eye infections neonatal specimens keep the secretions to do culture.3. Specimen collection and biochemical detection:PCT:ELFA (enzyme-linked fluorescent analysis); CRP:immune nephelometry detection.4. Statistical analysis:The study takes SPSS18.0statistical analysis software for data processing and analysis. Takinga=0.05as inspection level and P<0.05as the difference, which is statistically significant.χ2test and rank sum test is used to compare three groups of basic information; rank sum test, rank correlation, logistic regression analysis of the PCT influencing factors; rank sum test or analysis of variance comparison of the PCT, CRP and white blood cell count (WBC) differential; χ2test PCT difference; correlation analysis of the PCT and the use of antibiotics associated with CRP; repeated measure analysis of variance and rank correlation analysis of the PCT.Results1. Bacteria and other pathogens (viruses, syphilis, mycoplasma infection) infection PCT value:bacterial infection, PCT values increase significantly compared with other pathogens infection, which are statistically significant (P<0.05); Gram-negative bacteria (G-bacteria) and Gram-positive (G+bacteria) infection PCT value of the difference is not statistically significant (P>0.05).2. Systemic infection, local infection, and non-infected group of PCT, CRP and the WBC values:the PCT difference was statistically significant (He=24.82, P<0.05); of CRP difference is statistically significant (F=16.91, P<0.05,); the WBC difference is statistically significant (F=0.206, P>0.05).3. Different levels of infection PCT value:systemic infection group and the local infection group difference is statistically significant (P <0.05), and systemic infection in the PCT group and the non-infected group difference is statistically significant (P<0.05), local infection group and non-infected group PCT is no significant difference (P>0.05).4. Sensitivity of PCT and CRP in the diagnosis of neonatal infectious disease:The positive rates of infection and sensitivity by the PCT test is higher than CRP, which is statistically significant (P<0.05); Test specificity, positive predictive value, negativepredictive value of infection of PCT and CRP are of no difference, which is not statistically significant (P>0.05).5. Use correlation of Positive PCT value and antibiotic:There is a correlation, correlation size r=0.52, P<0.05, statistically significant. 6. PCT value of influencing factors:Logistic regression suggests that infection, age, preterm, the PCT value are the influencing factors.Conclusion1. The PCT level increases in neonatal infections, PCT level is related to the pathogens, extent, severity of infection, which is superior to the CRP, Blood routine and pathogenic bacteria. It can be regarded as the index of early diagnosis of neonatal infections and assessment of disease severity indicatorsone.2. The PCT level can guide the application of antibiotics, dynamic monitoring of PCT levels can be observed efficacy to guide therapy.3. Infection, age, preterm make effect on PCT levels.