Hypersensitive C-Reactive Protein, Procalcitonin And White Blood Cell Count In Neonatal Infection Diagnostic Value

Objective:This study is aimed to investigate the rapid diagnosis and treatment value of the high-sensitivity C- reactive protein(hs-CRP), procalcitonin(PCT) and white blood cells(WBC) count in the early neonatal infections.Methods:Research object: selected in January 2014- our new pediatric admitted during the period of January 2015 days of age 0 to 28 days, 37-40 weeks gestational age, birth weight between 2500-4000 g term newborns. According to clinical manifestations and laboratory test results points(1) the systemic infection group(sepsis group) 20 cases: the blood culture positive for the diagnosis of sepsis in 10 cases, clinical diagnosis of sepsis in 8 cases, sepsis with purulent meningitis in 2 cases;(2) local infection group 20 cases, including 10 cases of idiopathic pneumonia, pustular rash 3 cases, 4 cases were omphalitis, bacterial enteritis in 2 cases and urinary tract infection, 1 case and are the only one site infection;(3) a noninfectious group 40 cases, including neonatal swallowing syndrome10 cases, neonatal jaundice 20 cases, neonatal wet lung 10 cases, and so on. Three groups of children in the proportion of men and women, gestational age, weight and age has no statistical significance.Specimen collection: infection group of children on the day of admission and recovery period(7days) admission respectively adopt femoral venous blood 2 ml, detection of blood leukocyte count and classification, the hs- CRP and PCT, hospitalization for antibiotic treatment before femoral venous blood 1.5 ml do etiology detection and secretion of respiratory tract of children with pneumonia to return for culture, omphalitis, pustular rash, enteritis, children of urinary tract infections were gathering local drainage or secretions and urine will do training. The infection group with disposable blood leukocyte count and classification, the hs- CRP and PCT.Detection methods: the electrochemical luminescence method of quantitative detection of PCT, immune turbidimetric method is used to detect the hs- CRP, laser staining the WBC count, use Vitek2- compact automatic bacteria identification instrument for bacterial culture.Statistic alanalysis: application SPSS17.0 software for statistical processing. Each group of test results with mean±standard deviation(x+s) said. Using t test analysis, adopt the receiver-operating characteristic curve(ROC curve) to determine each index for infectious disease diagnostic sensitivity and specificity. With the linear correlation analysis to determine the correlation between indicators. Set P < 0.05 for the difference is significant.Results:1 Infection group of PCT in the blood, the hs- CRP and WBC concentration significantly higher than the group of infection, PCT in systemic infection group, hs- CRP and WBC concentration significantly higher than that of local infection group, the differences were statistically significant(P < 0.05). The PCT for the sensitivity and specificity to diagnose neonatal bacterial infectious diseases joint is better than that of the hs- CRP and white blood cells(WBC) count, the difference was statistically significant(P < 0.05).2 Early infection group of PCT concentration increase and change the hs- CRP levels were positively correlated, r = 0.784, increasing concentration of PCT is also positively correlated with the WBC change, correlation coefficient r = 0.629, hs- CRP and WBC were positively correlated, r = 0.579, the difference had statistical significance(P < 0.05).3 Local infection and systemic infection group were taken after born 7 indexes after treatment compared with before treatment, PCT, the difference of the hs- CRP before and after treatment was statistically significant(P < 0.001), while the WBC in the treatment of systemic infection group has no statistically significant difference(P > 0.05), before and after treatment in the local infection group difference was statistically significant(P < 0.001).Conclusion1 PCT in neonatal infectious disease early diagnosis value maximum, and its specific degrees compared with the sensitivity of joint were superior to the hs CRP, WBC, It can be used as auxiliary indexes in early diagnosis and differential diagnosis of neonatal infections.2 PCT can predict to some extent the traditional hs- level of CRP and WBC inflammatory indicators.3 PCT help determine the degree of disease, evaluation of treatment effect, guide the antibiotics application.