| 摘要: |
| 目的探讨脐血降钙素原（PCT）、C反应蛋白（CRP）水平对具有感染高危因素晚期早产儿早发感染的诊断价值。方法选取分娩后具有感染高危因素的晚期早产儿198例，根据感染结局分为感染组62例、无感染组136例，检测并比较两组新生儿脐血PCT、CRP水平，分析其诊断早发感染的灵敏度和特异度。结果感染组脐血PCT、CRP水平为（1.45±1.52）滋g/L、（17.56±15.07）mg/L，分别高于无感染组的（0.25±0.16）滋g/L、（3.73±2.82）mg/L（均P＜0.01）。感染组脐血PCT、CRP阳性率分别为74.2%、62.9%，分别高于无感染组的5.9%、2.9%（均P＜0.01）。PCT+CRP诊断晚期早产儿早发感染的灵敏度最高，为88.7%；CRP的特异度最高，为97.1%。结论脐血PCT+CRP水平对具有感染高危因素晚期早产儿早发感染具有一定的诊断价值，可指导临床抗生素的使用。 |
| 关键词: 脐血 降钙素原 C反应蛋白 早发感染 早产儿 |
| DOI：10.12056/j.issn.1006-2785.2017.39.8.2016-1832 |
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| Monosialotetrahxosy1 ganglioside combined with head mild hypothermia for neonatal hypoxic-ischemic encephalopathy |
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| Abstract: |
| Objective To evaluate the efficacy of monosialotetrahxosy1 ganglioside (GM1) combined with head mild hypothermia in treatment of neonatal hypoxic-ischemic encephalopathy(HIE). Methods Eighty seven newborns with moderate to severe HIE were randomly assigned into three groups to receive routine treatment (n=30), hypothermia treatments (n=27) or GM1 combined with hypothermia treatments (n=30). All patients received treatment within 6h after birth. Neonatal behavioral neurological assessment (NBNA) were conducted at postnatal age 1-3d, 4-6d and 7-10d. The concentration of nitrite (NO -), nitrotyrosine(NT) and superoxide dismutase (SOD) levels in plasma were assessed 7 days after treatment. Results The overall efficacy in GM1 combined with hypothermia group(73.3%) was significantly higher than that in hypothermia(55.5%) and routine
treatment(53.3%) group(P＜0.01). No significant difference of NBNA scores at postnatal age 1-3d was observed among three
groups (P ＞0.05). NBNA scores at 4-6 days and 7-10 days after birth in GM1 combined with hypothermia group were higher
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than those in routine and hypothermia treatment groups (all P ＜0.05). The level of NO2 and NT in GM1 combined with
hypothermia group were lower and the level of SOD was higher than those in routine treatment group (all P＜0.05). Conclusion GM1 combined with head mild hypothermia can effectively treat neonatal hypoxic-ischemic encephalopathy, which may be associated with the attenuation of nitrosative stress and lipid peroxidation by enhancing the activity of anti-oxidation enzyme. |
| Key words: GM1 Head mild hypothermia Hypoxic-ischemic encephalopathy |
