CRP和I/T比值在亚洲新生儿感染早期诊断中的价值

A T Ang, N K Ho, S E Chia
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引用次数: 0

摘要

新生儿感染的最大挑战是正确识别受感染的新生儿,而不是过度治疗那些没有感染的新生儿。我们研究了80名疑似脓毒症的亚洲新生儿。评估c反应蛋白(CRP)、总白细胞计数(TW)和未成熟与总中性粒细胞比值(I/T Ratio)的特异性、敏感性、阳性预测值和阴性预测值。采用荧光极化免疫测定技术(FPIT)定量测定CRP。36例阳性(血培养阳性或胸片示肺浸润)。使用FPIT, 98%的临床健康个体的CRP(小于或等于)1.0mg%。以CRP≤1.0mg%为标准时,其特异性为0.84 ~ 0.91,敏感性为0.22 ~ 0.50。然而,在应激条件下,如出生窒息和胎儿窘迫,CRP可能会略微升高。因此,以CRP小于等于1.5mg%为标准,其特异性为0.93-1.00,敏感性为0.14-0.33。阳性预测值为71% ~ 100%,阴性预测值为57% ~ 63%。正常I/T比值小于0.2。I/T特异性为0.75 ~ 0.91,敏感性为0.22 ~ 0.47。阳性预测值为60% ~ 76%,阴性预测值为58% ~ 66%。因此,CRP是非常特异的,特别是当它低于1.5mg%时,但不那么敏感。I/T虽然不那么特异,但也比敏感更特异。联合CRP和I/T作为脓毒症的标志物,只增加了其特异性(范围93%-100%),而没有增加其敏感性(范围16%-45%)。(摘要删节250字)
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The usefulness of CRP and I/T ratio in early diagnosis of infections in Asian newborns.

The greatest challenge in neonatal infection is to correctly identify an infected neonate and not to overtreat those who are not. We studied 80 Asian neonates suspected of sepsis. C-Reactive Protein (CRP), Total White Cell Count (TW) and Immature to Total Neutrophil Ratio (I/T ratio) were evaluated in terms of their specificity, sensitivity, positive and negative predictive values. CRP was measured quantitatively by Fluorescence Polarisation Immunoassay Technology (FPIT). There were 36 positive cases (positive blood culture or Chest Radiography [CXR] showed pulmonary infiltrates). Using the FPIT, CRP in 98% of clinically healthy individuals is (less than or equal to) 1.0mg%. When CRP is less than or equal to 1.0mg% is taken as norm, its specificity range from 0.84-0.91 and its sensitivity from 0.22-0.50. However, CRP may be marginally raised in conditions of stress like birth asphyxia and fetal distress. Thus when CRP less than or equal to 1.5mg% is considered as norm, its specificity range from 0.93-1.00 and its sensitivity from 0.14-0.33. The positive predictive value range from 71%-100% and the negative predictive value from 57%-63%. The normal I/T ratio is less than 0.2. The specificity of I/T range from 0.75-0.91 and the sensitivity range from 0.22-0.47. The positive and negative predictive values range from 60%-76% and 58%-66% respectively. Hence CRP is very specific especially when it is less than 1.5mg% but not as sensitive. I/T although less specific is also more specific than sensitive. Combining CRP and I/T as a marker of sepsis only increases its specificity (range 93%-100%) but not its sensitivity (range 16%-45%).(ABSTRACT TRUNCATED AT 250 WORDS)

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