关键词: 前降钙素, 败血症, 脑膜炎, 新生儿

Abstract:

Objective Procalcitonin(PCT) has been regarded as a marker of bacterial infection.The purpose of this study was to evaluate the diagnostic value of PCT in neonates with severe bacterial infection.Methods The serum PCT concentrations were measured in quantity with immunoluminometric assay and compared with C reactive protein(CRP) and leucocyte count(WBC) in 30 critically ill neonates and 30 non-infected neonates as control.Optimum sensitivity,specificity,predictive values and area under the receiver operating characteristic(ROC) curve were evaluated.Results The serum PCT at admission was much higher in neonates with severe bacterial diseases(media 7.82 μg/L;range 0.97～256.81 μg/L),compared with noninfected neonates as control(0.16 μg/L;(0.10～)1.49 μg/L).Area under the ROC curve was 0.99 for procalcitonin,0.62 for CRP and 0.60 for WBC.The cut off-concentrations for optimum prediction of severe bacterial diseases were:PCT>2 μg/L sensitivity was 87%,both the specificity and positive predictive value were 100%,negative predictive value 88% and CRP>20 mg/L.A sensitivity of 100% and negative predictive value of 100% were yielded and all patients with severe bacterial disease were identified when(PCT>)0.9 μg/L.Conclusion In critically ill neonates the PCT concentration at admission is a better diagnostic marker of infection than CRP and WBC.

Key words: procalcitonin, aepsis, meningitis, neonate