RDW-SD/PLT、PDW/PLT、PCT及联合检测——在新生儿胎粪吸入综合征的应用价值

RDW-SD/PLT, PDW/PLT, PCT and Combined Detection—Application Value in Neonatal Meconium Aspiration Syndrome

摘要: 目的：探讨红细胞分布宽度标准差与血小板比值(RDW-SD/PLT)、血小板分布宽度与血小板比值(PDW/PLT)、降钙素原(PCT)以及三者联合检测的水平变化在早期诊断新生儿胎粪吸入综合征(MAS)及识别重症的应用价值。方法：回顾性分析2020年6月至2025年6月收治的MAS 116例为病例组，根据MAS严重程度，将其分为轻症组(64例)和重症组(52例)，并选取同期收治的羊水清亮单纯(非感染、溶血及出血等病因)高胆红素血症新生儿146例作为对照组，比较RDW-SD/PLT、PDW/PLT、PCT及三者联合检测对MAS诊断及识别轻重症价值的效能。结果：病例组的RDW-SD/PLT、PDW/PLT、PCT水平均高于对照组(均P < 0.05)，且重症组高于轻症组(均P < 0.05)。三项指标联合检测对MAS诊断以及轻重症MAS诊断的ROC曲线下面积(95% CI)、敏感度、特异度分别为0.863 (0.820, 0.907)、86.2%、71.9%和0.919 (0.870, 0.967)、92.3%、81.2%。结论：RDW-SD/PLT、PDW/PLT、PCT三项指标联合检测显著提升了诊断效能，其对于MAS诊断及轻重症鉴别的AUC分别达到0.863和0.919，且敏感度与特异度均维持在较高水平(重症鉴别敏感度92.3%，特异度81.2%)。其具有显著的协同诊断价值，为MAS的早期诊断及重症风险预警提供了一个廉价且有效的实验室新方案。

Abstract: Objective: To investigate the application value of red blood cell distribution width standard deviation and platelet ratio (RDW-SD/PLT), platelet distribution width and platelet ratio (PDW/PLT), procalcitonin (PCT) and the combined detection of the three in the early diagnosis of neonatal meconium aspiration syndrome (MAS) and the identification of severe cases. Methods: Retrospective analysis of 116 cases of MAS admitted from June 2020 to June 2025 as the case group. According to the severity of MAS, they were divided into mild group (64 cases) and severe group (52 cases). 146 cases of hyperbilirubinemia neonates with clear amniotic fluid (non-infection, hemolysis and hemorrhage) were selected as the control group. The efficacy of RDW-SD/PLT, PDW/PLT, PCT and the combined detection of RDW-SD/PLT, PDW/PLT and PCT in the diagnosis and identification of MAS was compared. Results: The levels of RDW-SD/PLT, PDW/PLT and PCT in the case group were higher than those in the control group (all P < 0.05), and those in the severe group were higher than those in the mild group (all P < 0.05). The area under the ROC curve (95% CI), sensitivity and specificity of the combined detection of the three indicators for the diagnosis of MAS and the diagnosis of mild and severe MAS were 0.863 (0.820, 0.907), 86.2%, 71.9% and 0.919 (0.870, 0.967), 92.3%, 81.2%, respectively. Conclusion: The combined detection of RDW-SD/PLT, PDW/PLT and PCT significantly improved the diagnostic efficacy. The AUC for MAS diagnosis and mild and severe identification reached 0.863 and 0.919, respectively, and the sensitivity and specificity were maintained at a high level (severe identification sensitivity 92.3%, specificity 81.2%). It has significant collaborative diagnostic value and provides a cheap and effective laboratory new scheme for early diagnosis and severe risk warning of MAS.