Abstract：OBJECTIVE: To evaluate the clinical value of serum hypersensitive C-reactive protein (hsCRP) test in early diagnosis of early-onset infection in premature infants. METHODS: Thirty-five premature infants with early-onset infection, 50 premature infants with non-infectious diseases and 40 healthy premature infants 3 hrs after birth were enrolled. Serum hsCRP levels were measured by particle enhanced immunoturbidimetric assay. Diagnostic test of hsCRP was performed. RESULTS: Serum hsCRP levels shown as medium and inter-quartile ranges (M, Q75-25) were 2.19 and 4.96 mg/L respectively in the infection group, 0.41 and 0.61 mg/L respectively in the non-infectious disease group, and 0.24 and 0.28 mg/L respectively in the healthy group. Serum hsCRP levels in the infection group were significantly higher than those in the non-infectious disease and the healthy groups. When serum hsCRP test was used for the diagnosis of early-onset infection, the area under the ROC curve was 0.84, 95% confidence interval was 0.76-0.93, the diagnostic sensitivity and specificity were 74% and 86% respectively, and the positive and negative predictive values were 37% and 97% respectively. ConclusionsSerum hsCRP test is valuable in early diagnosis of early-onset infection in premature infants, but it can not serve as an independent diagnostic marker.［Chin J Contemp Pediatr, 2009, 11 (10):813-816］
BU Jun,SUN Jian-Hua,ZHU Jian-Xin. Hypersensitive C-reactive protein test in the diagnosis of early-onset infection in premature infants[J]. CJCP, 2009, 11(10): 813-816.
［1］Chiesa C, Panero A, Osborn JF, Simonetti AF, Pacifico L. Diagnosis of neonatal sepsis: a clinical and laboratory challenge ［J］. Clin Chem, 2004, 50(2):279-287.
［2］Roberts WL, Moulton L, Law TC, Farrow G, Cooper-Anderson N, Savory J, et al. Evaluation of nine automated high-sensitivity C-reactive protein methods: implications for clinical and epidemiological applications. Part 2［J］. Clin Chem, 2001, 47(3):418-425.
［4］Benitz WE, Han MY, Madan A, Ramachandra P. Serial serum C-reactive protein levels in the diagnosis of neonatal infection ［J］. Pediatrics, 1998, 102(4):E41-50.
［5］Carrigan SD, Scott G, Tabrizian M. Toward resolving the challenges of sepsis diagnosis ［J］. Clin Chem，2004, 50(8): 1301-1314.
［6］Ng PC, Li G, Chui KM, Chu WC, Li K, Wong RP, et al. Neutrophil CD64 is a sensitive diagnostic marker for earlyonset neonatal infection ［J］. Pediatr Res, 2004, 56(5): 796-803.
［7］Cicarelli LM, Perroni AG, Zugaib M, de Albuquerque PB, Campa A. Maternal and cord blood levels of serum amyloid A, C-reactive protein, tumor necrosis factor-alpha, interleukin-1beta, and interleukin-8 during and after delivery［J］. Mediators Inflamm, 2005, 2005(2): 96-100.
［8］Yoon BH, Romero R, Shim JY, Shim SS, Kim CJ, Jun JK. C-reactive protein in umbilical cord blood: a simple and widely available clinical method to assess the risk of amniotic fluid infection and funisitis［J］. J Matern Fetal Neonatal Med, 2003, 14(2):85-90.
［11］Ishibashi M, Takemura Y, Ishida H, Watanabe K, Kawai T. C-reactive proteins kinetics in newborns: application of a high-sensitivity analytic method in its determination［J］. Clin Chem, 2002, 48(7): 1103-1106.
［13］Malik A, Hui CPS, Pennie RA, Kirpalani H. Beyond the complete blood cell count and C-reactive protein: a systemic review of modern diagnostic tests for neonatal sepsis［J］. Arch Pediatr Adolesc Med, 2003, 157(6):511-516.
［14］Jorum N, Boscher C, Denizot S, Loubersac V, Winer N, Roze JC,et al. Umbilical cord blood procalcitonin and C reactive protein concentrations as markers for early diagnosis of very early onset neonatal infection ［J］. Arch Dis Child Fetal Neonatal Ed, 2006, 91(1): 65-66.
［15］Mishra UK, Jacobs SE, Doyle LW, Garland SM. Newer approaches to the diagnosis of early onset neonatal sepsis［J］. Arch Dis Child Fetal Neonatal Ed, 2006, 91(3): 208-212.
