Significance Of Early Diagnosis Of Early Septicemia In Premature Infants With PCT IL-6 And Hs-CRP

Objective: to evaluate the diagnostic value of three kinds of inflammatory factors,namely procalcitonin,interleukin-6,Highersensitivity C-reactive protein,in preterm infants with early septicemia.To clarify the diagnosis and treatment of premature septicemia of premature infants in our hospital.Methods: the clinical data of premature infants from January 2015 to December 2017 were analyzed retrospectively.Referring to the "Diagnostic and Therapeutic Program on Neonatal septicemia" formulated by the Neonatal Section of the Chinese Medical Association of Pediatrics in 2003,the participants were divided into septicemia group and non-septic group.According to the results of blood culture,the blood culture group was subdivided into two groups:confirmed septicemia group and clinical septicemia group.The positive predictive value,negative predictive value,sensitivity and specificity of Hypersensitivity CRP,interleukin-6 and procalcitonin were obtained.The area under the ROC curve was calculated to find the best combination for the diagnosis of sepsis.Results: three kinds of inflammatory factors,interleukin-6,procalcitonin and HypersensitivityCRP,were significantly higher in septicemia group than those in control group(P < 0.05),and interleukin-6,procalcitonin and Hypersensitivity CRP in children with septicemia and in clinical diagnosis of septicemia were significantly higher than those in control group(P <0.05).Two groups of children compared,The former is obvious Rise.By drawing ROC curve,the best truncation value of Hypersensitivity C-reactive protein is 4.73 mg / L,positive predictive value,negative predictive value,sensitivity and specificity are 83.33%84.69% and 85%,83%,respectively.The best truncation value of PCT is 4.56 mg / L,its sensitivity,specificity,positive predictive value,the negative predictive value and the AUC,respectively,were 95%,56%,68.34%,91.8%,68.34,respectively.The best truncationvalue of IL-6 is 57.6 ug / L,its sensitivity,specificity,positive predictive value,the negative predictive value and the AUC,respectively,were 66%,64%,64%,65.34%,0.789,respectively.The sensitivity,specificity,positive predictive value of Hypersensitivity CRP combined with interleukin-6 and procalcitonin combined with Hypersensitivity CRP,The negative predictive values were 83.21 and 84.48,the area under the ROC curve of the former was 0.879,and the area under the ROC curve of the latter was 0.879.The sensitivity,specificity and positive predictive value of interleukin-6 combined with procalcitonin were determined.The negative predictive value was 57.54 and 58.51,respectively.The area under the ROC curve was 0.822.The sensitivity of three cytokines combined with these three combinations was 0.822,specificity,positive predictive value and negative predictive value were 830.21 and 84.48,respectively.The best combination was Hypersensitivity CRP combined with procalcitonin,three inflammatory factors combined with Hypersensitivity CRP and interleukin-6.Conclusion: Hypersensitivity CRP combined with procalcitonin,HypersensitivityCRP combined with interleukin-6 and Hypersensitivity CRP,procalcitonin and interleukin-6 can improve the accuracy of clinical diagnosis of EONS in premature infants,which is rapid,convenient and worth popularizing.Sensitivity of HypersensitivityCRP and IL-6 in diagnosis of premature septicemia in premature infants It can be used to assist the diagnosis of premature septicemia in premature infants.Procalcitonin has high sensitivity,poor specificity and easy misdiagnosis,which leads to overtreatment.It is not recommended to use alone in auxiliary diagnosis of EONS.