| Objective Through the retrospective collection of clinical data,the ROC(receiver operator character curve)is used as the receiver operator character curve to analyze and explore arterial blood lactate,procalcitonin(PCT),and C-reactive protein,CRP)combined interpretation of the clinical significance of premature infants with late-onset sepsis assessment,to guide clinical early effective intervention treatment,and maximize the prognosis.Methods From June 2015 to August 2019,42 preterm infants who met the enrollment criteria without infection in our hospital were randomly selected as the control group,and 107 preterm infants with confirmed late-onset sepsis were selected as the research group during the same period.After admission,the selected children were tested for arterial blood lactate,PCT,CRP,platelet(PLT),and white blood cell(WBC)indicators.Children in the late-onset sepsis group were scored for critical neonatal cases(NCIS),and the children were divided into three groups A,B,and C according to NCIS,of which group A was non-critical illness(30 cases)and group B was critical illness(34 Cases),group C is critically ill(43 cases).According to the prognosis of the children,they were divided into death group and survival group,including 9 death group and 98 survival group,compare the levels of arterial blood lactic acid,procalcitonin,and C-reactive protein values between the infected group and the control group,the infection group with different severity levels,and the infection group with different prognosis,and evaluate the significance of each test index for the evaluation of the late-onset sepsis in premature infants and analyze it.The collected data was statistically analyzed and processed using SPSS 20.0 software.Results According to the receiver operating characteristic curve(ROC curve)analysis,the best cut-off points of CRP,PCT and arterial blood lactate for early diagnosis of late-onset sepsis in premature infants are 10.05 mg / l,0.53 ng / ml,2.70 mmol / L,The area under the curve(AUC)was 0.889,0.884,0.695,95% CI was 0.819-0.959,0.814-0.955,0.576-0.814,the combined detection AUC was 0.941,95% CI was0.894-0.989,combined detection was sensitive both sex and specificity are higher than those of CRP,PCT,and lactate alone,which is more accurate and reliable for assisting clinical early assessment of premature infants with late-onset sepsis.Arterial blood lactate,PCT,CRP,and mortality in group C were higher than those in group B and group A(P <0.05);arterial blood lactate,PCT,CRP,and mortality in group B were higher than group A(P <0.05);C Group PLT value is lower than Group B and Group A(P < 0.05),Group B PLT value is lower than Group A(P < 0.05);the difference is statistically significant(P <0.05).There was no significant differencebetween the two groups of WBC(P > 0.05)and no statistical significance(P >0.05).Arterial blood lactate,CRP,PCT and NCIS were negatively correlated(r =-0.707,-0.746,-0.839,P < 0.05),and arterial blood lactate,CRP,PCT and NCIS levels increased as NCIS decreased;The PLT value was positively correlated with the NCIS score score(r = 0.552,P <0.05),and the level of PLT value decreased as the NCIS score decreased.Conclusion The best cut-off value of arterial blood lactate,PCT and CRP for the diagnosis of late-onset sepsis in preterm infants can be obtained through ROC curve analysis.Accurately evaluate the child's condition to guide the clinic to give active and effective treatment,which can be used in clinical promotion... |
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