新生儿出生早期血清降钙素原浓度变化规律及其影响因素分析

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1、检验医学与临床２０１６年８月第１３卷第１６期LabMedClin，August２０１６，Vol．１３，No．１６·２２６７··论著·新生儿出生早期血清降钙素原浓度变化规律及其影响因素分析１２１１２许蔓春，廖扬，任广立，马恒颢，石玉玲（广州军区广州总医院：１．小儿科，２．检验科５１００１０）摘要：目的探讨新生儿出生早期血清降钙素原（PCT）变化规律及常见围产因素对PCT水平的影响。方法分析２０１２年１月至２０１４年１２月该院收治的无感染健康新生儿４７０例，其中足月儿２４０例，早产儿２３０例，分析其出生一周内血清PCT水平，采用多元线性回归分析胎龄等常见围产因素对PCT水平的

2、影响。结果足月儿及早产儿PCT水平在出生时极低，出生后１２h内均略上升，并分别于出生后≥１２～２４h及≥２４～４８h达峰值，随后均逐步下降，最后两者分别在出生后约７２h后及９６h后降至正常婴儿水平。多元回归分析提示早产儿的PCT水平与样本检测时间（出生日龄）及其胎龄大小相关，足月儿PCT水平仅与出生日龄相关。结论足月儿及早产儿在出生早期PCT生理波动规律有所不同，且早产儿胎龄与PCT水平相关，该发现对于新生儿早发细菌感染的诊断与鉴别诊断、指导临床合理使用抗菌药物有重要临床意义。关键词：降钙素原；足月儿；早产儿；胎龄；围产因素DOI：10．3969／j．issn．1672-

3、9455．2016．16．012文献标志码：A文章编号：１６７２-９４５５（２０１６）１６-２２６７-０３Analysisofchangesofprocalcitioninandinfluencingfactorsoninfantsduringtheearlyneonatalperiod１２１１２XUManchun，LIAOYang，RENGuangli，MAHenghao，SHIYuling（１．DepartmentofPediatrics；２．DepartmentofClinicalLaboratory，GeneralHospitalofGuangzhouMilita

4、ryCommand，Guangzhou，Guangdong５１００１０，China）Abstract：ObjectiveToinvestigatechangesofprocalcitionin（PCT）andinfluencingfactorsoninfantsduringtheearlyneonatalperiod．MethodsAtotalof４７０healthyneonatesincluding２４０termnewbornsand２３０pretermnewbornswereenrolledfromJanu-ary２０１２toDecember２０１４．Andthele

5、velofPCTbetweenbirthandthefirstweekoflifewasanalyzed．GestationalageandothercommonperinatalvariableswereinvestigatedtoseehowthefactorsinfluencedPCTconcentrationbymultivariableanalysis．ResultsLevelsofPCTwerelowestatbirthintermandpretermnewbornsandthenincreasedslightlywithin１２hafterbirth，whi

6、chgraduallyreachedthepeakvaluesat≥１２－２４hand≥２４－４８hafterbirth，andthendeclinedslowlytonormallevelsat７２hand９６hafterbirth．respectivelyinmultivariableanalysis，gestationalageandneonatalageinfluencedPCTconcentrationinde-pendentlyinpretermnewborns，andonlyneonatalagewasassociatedwithPCTvaluesinter

7、mnewborns．ConclusionTherearedif-ferentchangingrulesofPCTlevelintermandpretermbabiesduringtheearlyneonatalperiod，andgestationageisrelatedwithPCTconcentrationinpretermbabies．Thefindingsarehelpfulindetectingearly-onsetneonatalbacterialinfectionandrationaluseofantibioti