The Study Of Procalcitonin Combined With Coagulation Function Test In Judging The Severity And Prognosis Of Neonatal Infectious Diseases

Objective:To investigate the value of combined detection of procalcitonin and coagulation function test in judging the severity and prognosis of neonatal infectious diseases.Methods:From January 1, 2016 to December 31, 2016, 246 cases of newborns with infectious diseases,who were admitted in the neonatal department of the Second Affiliated Hospital of Kunming Medical University,they were selected as the subjects of the research, including preterm infants and full-term infants. All the selected newborns did not have any treatment before admission,at the first 24 hours after admission, blood samples were collected from newborn infants, and then four items of blood coagulation+DD+ATIII+FDP and PCT were detected.And we will collect the physiological parameters and laboratory test results. Preterm infants and full-term infants were divided into three groups according to the NCIS score,such as extremely dangerous group, dangerous group and non dangerous group. According to whether survive,the newborns were divided into death group and survival group. And we will Compare the procalcitonin and coagulation function test among them.Results:1.There was no statistically significant difference in gender, gestational age, age of onset, and birth weight between the groups of preterm and full-term infants (P<0.05).2. The NCIS score of the preterm infants in dangerous group was lower than that in non dangerous group,The NCIS score of the preterm infants in extremely dangerous group was lower than that in dangerous group and non dangerous group.The DD level of the preterm infants in dangerous group was lower than that in non dangerous group,The DD level of the preterm infants in extremely dangerous group was lower than that in dangerous group and non dangerous group. The difference was statistically significant (P < 0.05). Compared with non dangerous group and dangerous group, the level of PT?APTT and TT of extremely dangerous group were higher, the level of AT-III was significantly reducing,the level of FDP and PCT were significantly increased. The difference was statistically significant (P < 0.05). Compared with non dangerous group,the level of PCT?PT?APTT?TT?AT-III?FIB and FDP of dangerous group, there was no statistically significant difference.3. There was no statistically significant difference in FIB among the groups of full-term infants(P>0.05). The NCIS score of the full-term infants in dangerous group was lower than that in non dangerous group, The NCIS score of the full-term infants in extremely dangerous group was lower than that in dangerous group and non dangerous group.The DD level of the full-term infants in dangerous group was lower than that in non dangerous group, The DD level of the full-term infants in extremely dangerous group was lower than that in dangerous group and non dangerous group.The difference was statistically significant (P < 0.05). Compared with non dangerous group and dangerous group, the level of PT?APTT and TT of extremely dangerous group were extention, the level of AT-? was significantly reduction, the level of FDP and PCT were significantly increased. The difference was statistically significant (P <0.05). Compared with non dangerous group,the level of PCT?PT?APTT?TT?AT-?and FDP of dangerous group was no statistically significant difference.4. The NCIS score?AT-? and FIB of premature death group were lower than survival group, the level of PCT?DD and FDP were higher than survival group, the level of PT was higher than survival group, the difference was statistically significant(P < 0.05). the level of APTT and TT was no obvious higher than survival group, the difference was no statistically significant (P>0.05).5. The NCIS score?AT-? and FIB of full-term death group were lower than survival group, the level of PCT?DD and FDP were higher than survival group, the level of PT was higher than survival group, the difference was statistically significant (P < 0.05).the level of APTT and TT was no obvious higher than survival group, the difference was no statistically significant (P>0.05).6. By the ROC curve analysis, the serum PCT, D-D and PCT+DD of AUC were 0.981?0.978?0.992,which could predict a high accuracy of death. The NCIS score?FDP and PT could predicted a moderate accuracy of death. APTT?TT?AT-? and FIB could predicted a low accuracy of death. Serum PCT+DD prediction of neonatal infectious disease death performance, which was the largest Youden index among all indicators, Sensitivity was 96.67%, Specificity was 95.83%, the positive predictive value was 76.3%, the negative predictive value was 76.3%.Conclusion:1. To a certain extent,the NCIS score and serum PCT level of newborns can reflect the severity of neonatal infectious diseases.2. As the increase of severity of neonatal infection, the DD and FDP become obviously higher, PT?APTT and TT become higher, FIB become lower, AT-?become significantly lower. At the same tiome ,The clinical death risk is increasing,and the seven items of coagulation had certain reference value for the prognosis of newborns with infectious disease.3. Combining neonatal NCIS score and detection of coagulation function and serum PCT,we can determine the severity of neonatal infectious disease and assess prognosis more and more accurately.