| Part1The role of umbilical blood procalcitonin in early diagnosis of neonatal infectionBackgroundNeonatal infection is the main cause of rising neonatal morbidity and mortality. According to one nearest the cause of children death assessment report published by WHO that the main reasons for neonatal death were premature, neonatal sepsis, pneumonia and intrapartum asphyxia. With the development of the technology in neonatal intensive care in our country, the neonatal mortality declined year by year, however, the neonatal infection still is the main reason for perinatal morbidity excepting premature. The early diagnosis and effective therapy could remarkably improve the prognosis of neonatal infection so that it is important to search for more effective and earlier inflammation markers. Procalcitonin detection is one of the most studied and mature inflammation detection technologies so that it has great value in early diagnosis of neonatal infection. At present, there are less research for umbilical blood procalcitonin detection at home and abroad and some studies are controversial. It is theoretically possible that the umbilical blood detection has great value in the early diagnosis of neonatal infection for the reason that umbilical blood was the earliest sample from neonate. Thus, we mean to explore the role of umbilical blood procalcitonin in early neonatal infection through this research.ObjectiveTo explore the role of umbilical blood procalcitonin in early neonatal infection.Methods78neonate, who were born in the obstetrical department or/and were transferred to the neonatal ward of the Fifth People’s Hospital of Shanghai Affiliated to Fudan University from March2012to April2013, were enrolled. All the neonates were at the risk of infection and were diagnosed with neonatal infection. The umbilical blood was collected at birth and the peripheral blood was collected at3days after birth. Detecting the PCT both in umbilical blood and peripheral blood, hemogram, CRP and dividing the neonates into high PCT group and normal PCT group according to the detection result. Clinical material such as temperature, the volume of milk, reactivity and jaundice were collected both in two groups. We hoped to find out the correlation between the umbilical blood PCT and neonatal infection by analyzing the clinical data in two groups.Results 1.The high PCT group and the normal PCT group had no difference in gender, gestational age and birth weight.2.The peripheral blood CRP was normal both in high PCT group and normal PCT group.3.There were no significant difference in the absolute number of WBC, the percentage of neutrophilic granulocyte and lymphocyte, PCT between two groups except platelet.4.There has correlation between umbilical blood PCT and peripheral blood PCT whether there has no correlation between umbilical blood PCT and peripheral blood hemogram in high PCT group; There has no correlation between umbilical blood PCT and peripheral blood PCT and hemogram in normal PCT group.5. There was no difference between two groups for reactivity, the volume of milk and jaundice except for temperature during one week after birth.6. The use of antibiotics before delivery could not affect the clinical presentation such as temperature, reactivity, the volume of milk and jaundice in high PCT group, so did the peripheral blood inflammatory markers.ConclusionThe umbilical blood PCT probably was little pointless to the early diagnosis of neonatal infection. Part2Umbilical blood procalcitonin early diagnose neonatal infection for the neonates with PROMBackgroundThe premature rupture of membranes means embryolemma naturally broken before birth. The negative effects brought by PROM include fatal distress, premature, neonatal infection, etc. Neonatal infection has accepted as one of the most closely related factor with PROM and is correlated with neonatal morbidity and mortality. Procalcitonin has been proved to be an early inflammatory index in the early diagnosis of neonatal infection. At present, there are less research for umbilical blood procalcitonin detection at home and abroad. Therefore, we mean to explore the correlation between the umbilical blood procalcitonin and neonatal infection through this research.ObjectiveTo investigate the role of umbilical blood procalcitonin in early diagnosis of neonatal infection for the neonates with PROM.Methods37neonates with PROM also had been diagnosed with neonatal infection were recruited from the obstetrical department and neonatal ward of the Fifth People’s Hospital of Shanghai Affiliated to Fudan University from March2012to April2013. Umbilical blood was collected at birth and peripheral blood was collected at3days after birth. They were divided into the high PCT group and the normal PCT group according to their umbilical blood PCT. We hoped to know that the value of umbilical blood PCT detection in early diagnosis neonatal infection through the analysis of the clinical material in two groups.Results1. There had no difference in gender, gestational age and birth weight between high PCT group and normal PCT group.2. Both the high PCT group and the normal PCT group there had no significant difference in the absolute number of WBC, the percentage of neutrophilic granulocyte and lymphocyte, PCT excepting platelet. The peripheral blood CRP was normal in the two groups.3.There had no correlation between umbilical blood PCT and peripheral blood PCT, the absolute number of WBC, the percentage of neutrophilic granulocyte and lymphocyte and PLT in high PCT group; There had no correlation between umbilical blood PCT and peripheral blood PCT, the absolute number of WBC, the percentage of neutrophilic granulocyte except the percentage of lymphocyte and PLT in normal PCT group.4. Neither the high PCT group or the normal PCT group had difference in the temperature, reactivity, the volume of milk and jaundice during one week after birth.ConclusionThe umbilical blood PCT may be little pointless to early diagnosis of neonatal infection in the neonates with the history of premature rupture of membrane. |
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