Evaluation Of Combined Detection Of T Lymphocyte Subsets,C-reactive Protein And Procalcitonin For Diagnosis And Prognosis Of Neonatal Sepsis

Objective:To evaluate the value of T-lymphocyte subsets,procalcitonin(PCT)and C-reactive protein(CRP)for the diagnosis and prognosis of neonatal sepsis.Methods:100 term infants admitted from March 1,2017 to August 31,2017 were selected as study subjects,40 patients in the sepsis group,35 in the general infection group,and 25 in the non-infection group.In the infected group,T-lymphocyte subsets,CRP and PCT were detected before and after treatment.At the same time,blood cultures were performed before treatment;blood,T lymphocyte subsets,CRP,and PCT were detected in the non-infected group at one time.The three groups of T lymphocyte subsets,CRP,PCT levels were compared and analyzed,and the changes in the indicators of the infection group before and after treatment were compared and analyzed.The ROC curve was plotted to calculate the area under the curve,and the sensitivity,specificity,positive predictive value,negative predictive value,and Youden index of each index were calculated.Results:The positive rate of blood culture in the sepsis group was 22.5%,Among the positive results of blood culture,Gram-positive bacteria are mainly coagulase-negative staphylococcus,and Gram-negative bacteria are mainly Klebsiella pneumoniae.The expression of CD3~+,CD4~+,CD4~+/CD8~+in the T lymphocyte subsets of the sepsis group was significantly lower than that of the non-infective group and the general infection group,and the difference was statistically significant(P<0.05);CRP,PCT were significantly higher than non-infected and general infection groups,the difference was statistically significant(P<0.05).The above data in general infection group and non-infection group was not statistically significant(P>0.05).There was no significant difference in CD8~+between the two groups(P>0.05).The areas under ROC curve of CRP,PCT and CRP+PCT were 0.821,0.893,and 0.933,respectively.The blood culture had the lowest positive rate in the diagnosis of sepsis,and the highest in PCT,followed by CRP;The sensitivity and specificity of combined detection of CRP and PCT are higher than that of individual detection.In addition to CD8~+,the changes of PCT,CRP and T lymphocyte subsets were satistically significant before and after sepsis treatment(P<0.05).Changes before and after treatment of PCT,CRP,CD3~+,and CD4~+in the general infection group were statistically significant(P<0.05),and there was no statistically significant of CD8~+and CD4~+/CD8~+data(P>0.05).Conclusion:1.Among the positive results of blood culture,Staphylococcus was the main pathogen,followed by Klebsiella pneumoniae.2.The levels of CRP and PCT in blood of severely infected children were significantly higher than those of normal infected and non-infected children.Compared with CRP and blood culture,PCT was a more sensitive indicator for diagnosing neonatal sepsis.3.In newborns,their cellular immunity is inhibited during severe infection,resulting in low immune function.4.Combined detection of T lymphocyte subsets,CRP and PCT facilitates early diagnosis and prognosis of sepsis.