联合测定免疫球蛋白M和髓过氧化物酶对新生儿细菌感染的早期诊断意义

Significance of Detection of Immunoglobulin M Combined With Myeloperoxidase in Early Diagnosis of Neonatal Bacterial Infection

目的探讨血清免疫球蛋白(immunoglobin,Ig)M和髓过氧化物酶(myeloperoxidase,MPO)联合测定对新生儿细菌感染的早期诊断意义。方法随机选择2007年7月至2008年7月入本院后,血、尿、脑脊液和脐部分泌物培养经细菌学检测呈阳性的足月新生儿25例纳入感染组,选取同期本院新生儿科收治的无细菌感染征象的足月新生儿25例纳入对照组。分别采用比浊法和比色法测定两组患儿血清中IgM和髓过氧化物酶水平(本研究遵循的程序符合成都市儿童医院人体试验委员会所制定的伦理学标准,得到该委员会批准,并与试验患儿监护人签署临床研究知情同意书)。结果感染组(第1次血样标本采集)和对照组治疗前血清IgM和髓过氧化物酶值分别为(0.51±0.14)g/L和(0.57±0.11)△A/min及(0.24±0.14)g/L和(0.17±0.08)△A/min;两组比较,差异有显著意义(P<0.05)。感染组治疗后(第2次血样标本采集),血清中IgM和髓过氧化物酶值分别为(0.64±0.13g)g/L和(0.25±0.09)△A/min,与治疗前相比,差异有显著意义(P<0.05)。结论血清IgM与髓过氧化物酶联合测定,对早期诊断新生儿细菌感染有一定的临床实用价值。

Objective To evaluate the early diagnosis and clinical significance of detection of immunoglobulin M（IgM） combinded with myeloperoxidase（MPO） in neonates with bacterial infection： Methods From July 2007 to July 2008, 25 full-term neonates who were confirmed by bacterial detection of blood, urine, cerebrospinal fluid, and the culture of umbilical secretions were randomly selected into infected group. The other 25 full-term neonates without bacterial infection were chosen as control group. Both groups detected the level of immunoglobulin M and myeloperoxidase by nephelometry and colorimetry. Informed consent was obtained from all participants. Results The concentrations of immunoglobulin M in serum and myeloperoxidase in pre-therapy of infected group and control group were （0.51± 0. 14） g/L and （0.57±0.11）△A/min, （0.24±0.14）g/L and （0.17±0.08）△A/min, respectively. There had significant diference between the pre-therapy of infected group and control group （P 〈 0. 05）. However, the concentration of immunoglobulin M in serum increased to （0.64±0.13）g/L and myeloperoxidase reduced to （0.2±0.09）△A/min in second sampling in post-therapy of infected group, the significant difference was found in the concentration of immunoglobulin M in serum and myeloperoxidase between before and after the treatment in infected group （P〈0.05）. Conclusion The detection of concentration of immunoglobulin M in serum and myeloperoxidase are valuable for early diagnosis of bacterial infection in newborns.