炎症指标及细胞因子检测在新生儿败血症早期诊断中的应用价值

Application Potential of Inflammatory Markers and Cytokines Detection in Early Diagnosis of Neonatal Sepsis

目的探讨WBC、N%、CRP、PCT、IL-6、IL-27、IL-10、TNF-α指标在新生儿败血症早期诊断中的临床应用价值.方法采用流式细胞术检测外周血WBC、N%;采用免疫比浊法检测全血中CRP,免疫色谱分析法检测血浆中PCT;采用酶联免疫吸附试验(ELISA)测定患儿血浆中IL-27、IL-6、IL-10、TNF-α水平.结果新生儿败血症组第一天和第三天WBC、N%、CRP及PCT水平明显高于第七天及对照组(P<0.05),第三天CRP浓度最高;联合检测炎症指标有利于提高其敏感性和特异性;败血症患儿第一天和第三天体内IL-6、IL-10、TNF-α水平明显高于第七天及健康对照组,败血症患儿体内IL-6、IL-27浓度第三天达到最高水平(P<0.05).结论败血症患儿体内细胞因子IL-6、IL-27、IL-10、TNF-α水平在病情处于不同时间段的浓度不同;不同观察指标及不同指标联合检测的诊断灵敏度及特异性不同,联合及连续检测WBC、N%、PCT水平有利于提高对新生儿败血症的早期诊断价值.

Objective To explore the diagnostic value of WBC,N%,CRP,PCT,together with IL-6,IL-27,IL-10,and TNF-αfor early diagnosis of neonatal sepsis.Methods Flow cytometry was used to detect WBC and N%.The CRP and PCT were detected with both immune turbidity and the immunochromatography in the sera of patients.The levels of IL-6,IL-27,IL-10 and TNF-αwere measured with enzyme linked immunosorbent assay.Results The levels of WBC,N%,CRP and PCT on days 1 and 3 were higher than those on day 7(P<0.05).Concentration of CRP on day 3 and PCT on day 1 was elevated compared to the other groups.The levels of IL-6,IL-10 and TNF-αon days 1 and 3 were obviously higher than those on day 7(P<0.05)whereas IL-6 and IL-27 were found to be increased on day 3 in the neonatal patients with sepsis(P>0.05).Conclusion The levels of cytokines IL-6,IL-2 7,IL-1 0 and TNF-αvaried with the courses of neonatal sepsis.Combined detection of WBC,N%,PCT as well as the cytokines may be helpful for the early diagnosis of neonatal sepsis.