- 期刊
新生兒感染症之指標：C－反應性蛋白質(C-Reactive Protein. CRP)
A Parameter of Neonatal Infection - C-Reactive Protein (CRP)
摘要
本研究採取596個正常成熟新生兒（懷孕週數為38至40週，出生體重大於2,500公克，Apgar分數皆為8分以上）之血清為對象以定量其血中CRP之值。除了臍帶血之汁，這些新生兒分別在出生後12小時、6小時、12小時及滿1天至10天之內，經由足跟或週邊靜脈採血0.3西西來測定血中CRP之定量值。我們發現正常新生兒血中CRP值在出生後數小時之內急速地上昇，而在出生後第2天及第3天達到最高峰，然後在出生後第4天以後會再急速地下降，以達到一個正常且穩定之血清值。而此正常的CRP值之變化也隨著嬰兒生產之方式的不同而有差異；其中上昇最為明顯者，莫過經由陰道生產的初產婦以及經陣痛後才行帝王切開術出生的嬰兒。除了這些足月產之新生兒之外，161個採自早產兒之血清也以同樣之方法測定CRP之值，我們發現早產兒與足月早新生兒血清中CRP之定量值間並無統計學上之差異，而且出生後血中CRP值之變化也相同，因此我們認為早產兒製造 CRP 之能力與足月新生兒無異。在 12 例證實為細菌戚染之新生兒中，其中的11例血中CRP值皆有明顯或異常的上昇，只有一位敗血性休克之病兒，因在入院數小時之內卽死亡，其血中CRP值未呈現異常之上昇，而較定義為偽陰性。同時在12位正常新生兒之控制組中，他們血清中CRP值皆未呈現異常的上昇，皆認為是真陰性。所以我們認為速續地測定新生兒血清中CRP值之變化，可以早期正確地診斷新生兒感染症。
關鍵字
無資料並列摘要
Tillet and Francis (1930) discovered an unidentified substance in the sera of patients with pneumonia which was precipitated with the C-fraction polysaccharide of pneumococci. In 1941, the protein character of this substance was established by Avery; hence its name-C-reactive protein (CRP). CRP is not a constituent of the blood of normal subjects, but it is produced as a nonspecific indication during inflammatory reaction. To measure CRP quantitatively, 0.3ml of whole blood was obtained by hill prick. The serum CRP of 596 blood samples obtained from normal term neonates and 161 samples from preterm infants were measured quantitatively by rate nephelometry immunoassay using a CRP reagent kit (Beckman Co.) at their 2nd, 6th, 12th hour and daily till 10th day of life. Among these studied, we found CRP value rised rapidly within several hours after delivery with the peak value at 2nd and 3rd postnatal age, then it declined gradually after 4th day of life. The curves plotted from these CRP values were different from various delivery methods. The rise of CRP was most prominant in those newborns born by primipara mothers and deliveried vaginally as well as those by C/S delivery alter the onset of labor pain. Among 24 neonates suspected to be infected, 12 of them were proved to have bacterial infection. Of those, they had a significant elevation of CRP values. Only one septic shocky victim expired within 4 hours after admission regarding as a false negative.