EOS风险计算器联合血清C反应蛋白、降钙素原对新生儿早发型败血症的预测价值

Predictive value of the EOS risk calculator combined with serum C-reactive protein and procalcitonin in early-onset sepsis in neonates

摘要:

目的 探讨EOS风险计算器（SRC）联合血清C反应蛋白（CRP）、降钙素原（PCT）在预测新生儿早发型败血症（EOS）中的价值。方法 选取2021年1月—2021年12月在瑞安市人民医院分娩的胎龄≥ 34周的286例新生儿作为研究对象。新生儿按照1∶1的比例分为A组与B组。A组实施SRC评分辅助的抗菌药物管理；B组实施新生儿败血症治疗方案的抗菌药物治疗。比较两组入院时SRC评分、住院时间、抗生素使用率及并发症发生率。286例新生儿中，将95例确诊EOS的新生儿作为EOS组，191例未感染的新生儿作为对照组，均进行风险评分并检测血清CRP、PCT水平。绘制受试者工作特征（ROC）曲线分析EOS计算器联合血清CRP、PCT在新生儿EOS中的预测效能。结果 A组入院时SRC评分较B组高（P <0.05），住院时间较B组短（P <0.05），抗生素使用率、并发症发生率均较B组低（P <0.05）；EOS组的风险评分及CRP、PCT水平均高于对照组（P <0.05）。ROC曲线分析结果显示，SRC评分联合血清CRP、PCT在新生儿EOS中的预测效能最高，敏感性、特异性分别为97.0%（95% CI：0.871，0.981）、90.8%（95% CI：0.891，0.965），ROC曲线下面积为0.973（95% CI：0.949，0.997），高于单项检测。结论 EOS计算器联合血清CRP、PCT在预测新生儿EOS中表现出高敏感性和特异性，能够有效提高EOS的诊断准确率，减少不必要的抗生素使用和并发症的发生，对早期识别及治疗新生儿EOS具有重要的临床应用价值。

Abstract:

Objective To investigate the predictive value of the EOS Risk Calculator (SRC) combined with serum C-reactive protein (CRP) and procalcitonin (PCT) levels in early-onset sepsis (EOS) in neonates.Methods This study included 286 neonates with a gestational age of ≥ 34 weeks, born at Rui'an People's Hospital between January 2021 and December 2021. The neonates were divided into two groups: Group A and Group B, with a 1:1 ratio. Group A received SRC-assisted antibiotic management, while Group B received antibiotics based on standard neonatal sepsis treatment protocols. The SRC scores at admission, length of hospital stay, antibiotic usage rate, and incidence of complications were compared between the two groups. Among the 286 neonates, 95 were diagnosed with EOS and classified as the EOS group, while the remaining 191 uninfected neonates served as the control group. Risk scores and serum levels of CRP and PCT were assessed in both groups. The predictive efficacy of the EOS Risk Calculator combined with serum CRP and PCT for EOS was evaluated using a Receiver Operating Characteristic (ROC) curve analysis.Results Group A had significantly higher SRC scores at admission, shorter hospital stays, and lower antibiotic usage and complication rates compared to Group B (P < 0.05). The EOS group had higher risk scores and serum levels of CRP and PCT than the control group (P < 0.05). The ROC curve analysis demonstrated that the combination of SRC scores with serum CRP and PCT levels provided the highest predictive value for EOS, with a sensitivity of 97.0% (95% CI: 0.871, 0.981) and specificity of 90.8% (95% CI: 0.891, 0.965). The area under the ROC curve was 0.973 (95% CI: 0.949, 0.997), surpassing the predictive value of individual markers.Conclusion The EOS Risk Calculator combined with serum CRP and PCT levels exhibits high sensitivity and specificity in predicting EOS in neonates. This approach can improve diagnostic accuracy for EOS, reduce unnecessary antibiotic use, and lower the incidence of complications, offering significant clinical value for the early identification and treatment of EOS in neonates.