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

Abstract

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

CLC Number:

R722.13+1

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.

Figures/Tables 4

Table 1

Table 2

Table 3

Fig. 1

References 22

[1]	中华医学会儿科学分会新生儿学组,中华儿科杂志编辑委员会. 新生儿败血症诊断与治疗专家共识（2024）[J]. 中华儿科杂志,2024,62(10):931-940.
[2]	Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis[J]. Lancet, 2017, 390(10104): 1770-1780.
[3]	Fleischmann⁃Struzek C, Goldfarb DM, Schlattmann P, et al. The global burden of paediatric and neonatal sepsis: a systematic review[J]. Lancet Respir Med, 2018, 6(3): 223-230.
[4]	Giannoni E, Dimopoulou V, Klingenberg C, et al. Analysis of antibiotic exposure and early⁃onset neonatal sepsis in Europe, North America, and Australia[J]. JAMA Netw Open, 2022, 5(11): e2243691.
[5]	Shaaban HA, Safwat N. Mean platelet volume in preterm: a predictor of early onset neonatal sepsis[J]. J Matern Fetal Neonatal Med, 2020, 33(2): 206-211.
[6]	林胜楠, 富建华. 新生儿败血症生物标志物的研究进展[J]. 中华新生儿科杂志(中英文), 2022，37(6): 572-576.
[7]	中国医药教育协会感染疾病专业委员会. 感染相关生物标志物临床意义解读专家共识[J]. 中华结核和呼吸杂志,2017,40(4):243-257.
[8]	中华医学会儿科学分会新生儿学组,中国医师协会新生儿科医师分会感染专业委员会. 新生儿败血症诊断及治疗专家共识(2019年版)[J]. 中华儿科杂志,2019,57(4):252-257.
[9]	Fleischmann C, Reichert F, Cassini A, et al. Global incidence and mortality of neonatal sepsis: a systematic review and meta⁃analysis[J]. Arch Dis Child, 2021, 106(8): 745-752.
[10]	Mukhopadhyay S, Puopolo KM, Hansen NI, et al. Impact of early⁃onset sepsis and antibiotic use on death or survival with neuro⁃developmental impairment at 2 years of age among extremely preterm infants[J]. J Pediatr, 2020, 221: 39-46.
[11]	Ting JY, Synnes A, Roberts A, et al. Association between antibiotic use and neonatal mortality and morbidities in very low⁃birth⁃weight infants without culture⁃proven sepsis or necrotizing enterocolitis[J]. JAMA Pediatr, 2016, 170(12): 1181-1187.
[12]	Bethou A, Bhat BV. Neonatal sepsis⁃newer insights[J]. Indian J Pediatr, 2022, 89(3): 267-273.
[13]	王思云. 降钙素原在新生儿早发型败血症中的诊断价值[D]. 重庆: 重庆医科大学, 2020.
[14]	赵双葵,许燕萍. 新生儿败血症早期诊断生物标志物的研究进展[J]. 国际儿科学杂志,2024,51(5):331-334.
[15]	赵改. 补体水平对早产儿早发脓毒症的诊断价值[J]. 中国中西医结合儿科学, 2023, 15(6): 536-539.
[16]	许普, 王来栓. 病原微生物宏基因组检测在新生儿感染性疾病中的应用[J]. 中华实用儿科临床杂志, 2020, 35(11): 820-823.
[17]	Sanghavi A, Desai S, Nanavati R, et al. Correlation of haematological parameters and C-reactive protein between cord blood and first post⁃natal blood sample in preterm neonates: a prospective observational study[J]. J Paediatr Child Health, 2020, 56(6): 922-927.
[18]	Heeger LE, Koster MIJ, Caram⁃Deelder C, et al. Umbilical cord blood as an alternative to neonatal blood for complete blood count: a comparison study[J]. J Pediatr, 2024, 271: 114059.
[19]	张智源, 林霓阳, 房晓祎. 新生儿早发型败血症诊断方法的研究进展[J]. 发育医学电子杂志, 2019, 7(1): 51-54.
[20]	Thukral A. Umbilical cord blood culture for neonatal sepsis: do we have an answer[J]. Indian J Pediatr, 2020, 87(10): 779-780.
[21]	Rodrigues Wilde MO, Mezadri T, Gouveia PB, et al. Prediction of early⁃onset neonatal sepsis in umbilical cord blood analysis: an integrative review[J]. J Matern Fetal Neonatal Med, 2022, 35(25): 10187-10198.
[22]	Su H, Chang SS, Han CM, et al. Inflammatory markers in cord blood or maternal serum for early detection of neonatal sepsis—a systemic review and meta⁃analysis[J]. J Perinatol, 2014, 34(4): 268-274.

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）

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

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 4

References 22

Related Articles 13

Recommended Articles

Metrics

Comments

[1]	Lijuan ZHENG, Fumin XUE, Jing YU. Diagnostic value of GGT combined with DBIL for biliary atresia in different age groups of children [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(3): 231-236.
[2]	LIU Biao, ZHANG Guoqing. Clinical value of methemoglobin in early identification of gastrointestinal symptom-related infection in premature infants [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2024, 16(1): 46-50.
[3]	YANG Jiali, ZHAI Manman, LI Zhihao. Changes of serum PCT, CRP and IL-6 levels in pediatric bone and joint infections and their clinical significance [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2021, 13(2): 138-.
[4]	ZHOU Meixia, ZHOU Hao.. Analysis of the clinical value of ultrasonography in the early diagnosis of pediatric hip dysplasia [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2020, 12(6): 521-.
[5]	ZHOU Meixia, ZHOU Hao. Clinical value of ultrasonography in the early diagnosis of idiopathic precocious puberty in girls [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2020, 12(5): 430-433.
[6]	ZHENG Lijuan, YU Jing, LI Xiaoqin , WANG Xianghui.. Clinical value of laboratory test indicators in children with Henoch-Schonlein purpura [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2019, 11(6): 499-502.
[7]	LENG Xiuzhi. Application of combined detection of white blood cell count, procalcitonin and C-reactive protein in the diagnosis of children with community-acquired pneumonia [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2018, 10(4): 323-326.
[8]	SUN Wen, YU Jian, ZHANG Feifei, SHI Yumin. Clinical experience of Professor YU Jian in treating GVHR after umbilical cord blood stem cell transplantation [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2018, 10(4): 360-362.
[9]	LI Zhengqiu, YANG Lihua, LIU Lanxiang, LIU Yunhua, JIN Shijie. Value of PCT, hs-CRP and WBC in the diagnosis of respiratory tract infection in children [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2018, 10(2): 156-158.
[10]	LUO Lan，YAO Zhenya，ZHU Desheng. Determination of prothrombin time and C-reactive protein in early childhood bacterial sepsis [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2017, 9(4): 324-326.
[11]	LI Xianping, HUANG Haibo. Clinical value of C-reactive protein detection in children with central nervous infection [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2017, 9(3): 243-245.
[12]	FENG Jin. Clinical study on the early diagnosis and treatment methods for atypical neonatal purulent meningitis [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2017, 9(3): 259-261.
[13]	ZHENG Hewen.. [J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2017, 9(2): 147-149.