脐带血中白细胞计数联合C反应蛋白早期诊断新生儿早发型败血症的价值

doi:10.20274/j.cnki.issn.1674-3865.2025.03.009

中国中西医结合儿科学 ›› 2025, Vol. 17 ›› Issue (3): 237-241.doi: 10.20274/j.cnki.issn.1674-3865.2025.03.009

脐带血中白细胞计数联合C反应蛋白早期诊断新生儿早发型败血症的价值

陈宗礼¹, 蔡思乾², 李广飞³, 李璐¹, 罗克踊¹()

563000 贵州遵义, 遵义市第一人民医院/遵义医科大学第三附属医院新生儿科(陈宗礼，李璐，罗克踊)
564500 贵州仁怀, 贵州省仁怀市妇幼保健院儿科(蔡思乾)
564300 贵州务川, 贵州省务川县人民医院新生儿科(李广飞)

收稿日期:2025-01-13 修回日期:2025-03-08 出版日期:2025-06-25 上线日期:2025-06-25
通讯作者: 罗克踊 E-mail:339350772@qq.com
作者简介:陈宗礼(1992?)，男，医学硕士，主治医师。研究方向：新生儿败血症与脑损伤的早期诊治
基金资助:
贵州省教育厅高等学校科学研究项目(黔教技〔2022〕239号)

Value of white blood cell count combined with C-reactive protein in umbilical cord blood for the early diagnosis of early⁃onset neonatal sepsis

Zongli CHEN¹, Siqian CAI², Guangfei LI³, Lu LI¹, Keyong LUO¹()

^1.The First People's Hospital of Zunyi/The Third Affiliated Hospital of Zunyi Medical University，Zunyi 563000，China
^2.Renhuai Maternal and Child Health Hospital, Renhuai 564500，China
^3.Wuchuan County People's Hospital, Wuchuan 564300，China

Received:2025-01-13 Revised:2025-03-08 Published:2025-06-25 Online:2025-06-25
Contact: Keyong LUO E-mail:339350772@qq.com
Supported by:
Scientific Research Project of Higher Education Institutions of the Department of Education of Guizhou Province

摘要/Abstract

摘要：

目的探讨脐带血中白细胞计数联合C反应蛋白早期诊断新生儿早发型败血症的价值。方法采用前瞻性巢式病例对照研究方法，选取2022年10月至2024年9月遵义地区三家医院新生儿科收治的疑似新生儿早发型败血症患儿184例，根据最终是否确诊为早发型败血症，将其分为败血症组122例和非败血症组62例。比较两组脐带血中白细胞计数、C反应蛋白的变化，利用受试者工作特征（ROC）曲线分析白细胞计数联合C反应蛋白对新生儿早发型败血症早期诊断价值。结果败血症组白细胞计数、C反应蛋白水平均高于非败血症组，差异有统计学意义（P<0.05）；ROC曲线分析显示，联合检测的诊断价值明显高于单独检测白细胞计数、C反应蛋白，其中根据曲线下面积（AUC）判断诊断价值：白细胞计数+C反应蛋白>C反应蛋白>白细胞计数；诊断效能：AUC为0.901，敏感度为0.857，特异度为0.826。结论早发型败血症新生儿脐带血中白细胞计数、C反应蛋白水平呈高表达，对其早期诊断具有很好的临床应用价值；且获取血液样本无创无痛，能较大程度解决目前外周血液检测项目创伤性大的问题；同时白细胞计数、C反应蛋白检测技术成熟，且价格便宜、耗时短，有望作为新生儿早发型败血症早期诊断指标的有益补充。

关键词: 新生儿早发型败血症, 脐带血, C反应蛋白, 白细胞计数, 早期诊断

Abstract:

Objective To explore the value of white blood cell count combined with C-reactive protein in umbilical cord blood for the early diagnosis of early?onset neonatal sepsis. Methods A prospective nested case?control study was conducted in 184 newborns with suspected early?onset sepsis admitted to the neonatal departments of three hospitals in Zunyi area from October 2022 to September 2024. They were divided into the sepsis group（122 cases） and the non?sepsis group（62 cases） according to whether they were finally diagnosed with neonatal EOS. The white blood cell count and C-reactive protein in umbilical cord blood of the two groups were compared, and the ROC curve was used to analyze the value of the white blood cell count combined with C-reactive protein for the early diagnosis of neonatal EOS. Results The white blood cell(WBC) count and level of C-reactive protein in the sepsis group were higher than those in the non?sepsis group, and there were statistical differences(P<0.05). ROC curve analysis showed that the diagnostic value of the combined detection was significantly higher than that of detecting WBC or CRP alone. According to the area under the curve (AUC), the order of diagnostic value was: WBC+CRP > CRP > WBC. Regarding the diagnostic efficacy: the AUC was 0.901, the sensitivity was 0.857, and the specificity was 0.826. Conclusion The WBC and CRP levels in the umbilical cord blood of neonates with EOS are highly expressed, which has good clinical application value for the early diagnosis of neonatal EOS. Meanwhile, obtaining blood samples is non?invasive and painless, which can largely make up for the shortcomings of the current peripheral blood detection, such as being highly traumatic. At the same time, the detection techniques of WBC and CRP are mature and inexpensive with short duration, which is expected to serve as beneficial supplements to the early diagnostic indicators of early?onset sepsis (EOS) in neonates.

Key words: Early?onset sepsis in neonates, Umbilical cord blood, C-reactive protein, White blood cell count, Early diagnosis

中图分类号:

R722.13+1

陈宗礼, 蔡思乾, 李广飞, 李璐, 罗克踊. 脐带血中白细胞计数联合C反应蛋白早期诊断新生儿早发型败血症的价值[J]. 中国中西医结合儿科学, 2025, 17(3): 237-241.

Zongli CHEN, Siqian CAI, Guangfei LI, Lu LI, Keyong LUO. Value of white blood cell count combined with C-reactive protein in umbilical cord blood for the early diagnosis of early⁃onset neonatal sepsis[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(3): 237-241.

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参考文献 22

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组别	n	白细胞计数 [M(P₂₅,P₇₅),×10⁹]	C反应蛋白（x±s，mg/L）
非败血症组	62	12.16（9.08，16.58）	1.89±0.31
败血症组	122	25.07（11.16，31.20）	5.26±1.28
Z/t值		37.265	3.419
P值		<0.001	<0.001

指标	截断值	AUC	敏感度	特异度	阳性预测值	阴性预测值
C反应蛋白	2.47	0.651	0.429	0.892	70.8%（75/106）	60.3%（47/78)
白细胞计数	17.16	0.638	0.451	0.857	72.3%（94/130）	51.9%（28/54）
白细胞计数+C反应蛋白		0.901	0.857	0.826	91.7%（111/121）	82.5%（52/63）

脐带血中白细胞计数联合C反应蛋白早期诊断新生儿早发型败血症的价值

Value of white blood cell count combined with C-reactive protein in umbilical cord blood for the early diagnosis of early⁃onset neonatal sepsis

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