血清IL-6、CRP、PCT水平对新生儿败血症的诊断价值

Diagnostic value of serum interleukin-6,C-reactive protein and procalcitonin on neonatal sepsis

目的探讨IL-6、C反应蛋白(CRP)、降钙素原(PCT)诊断新生儿败血症的价值。方法选择临床诊断为败血症的患儿67例(观察组),另选同期无感染症状的30例新生儿作为对照组。采用ELISA双抗夹心法测定两组IL-6水平,固相免疫层析法半定量测定PCT水平,定量免疫速率比浊法测定CRP水平;以临床常用标准作为阳性诊断阈值,观察各指标诊断新生儿败血症敏感性、特异性、阳性预测值、阴性预测值及约登指数。以灵敏度为纵坐标,1-特异度为横坐标,分析ROC曲线,从而确定检测的最佳阈值。结果IL-6的敏感性、特异性、阳性预测值、阴性预测值和约登指数及ROC曲线下的面积值均优于CRP和PCT。而三个指标联合诊断的敏感性优于各指标独立诊断。结论IL-6对新生儿败血症有很好的临床诊断价值;疑诊新生儿败血症者应考虑多个指标联合应用,以提高诊断准确率。

Objective To investigate the diagnostic significance of IL-6, C-reactive protein（CRP） and procalcitonin （PCT） on neonatal sepsis. Methods Sixty-seven cases with a clinical diagnosis of sepsis were selected as the observed group, and 30 cases of newborns without symptoms of infection were included as the control group. IL-6, PCT and CRP were measured by Double-antibody sandwich ELISA method, solid-phase semi-quantitative immunochromatography, and quantitative immunization rate turbidimetry, respectively, using cutoff applied on clinic. The sensitivity, specificity, positive predictive value, negative predictive value, Youden＇s index of three biomarkers were calculated. And the ROC was described for further analysis. Results The sensitivity, specificity, positive predictive value, negative predictive value, Youden＇s index and the area under the curve of ROC of IL-6 were better than those of CRP and PCT. And the combination of three biomarkers had higher sensitivity than that of IL-6, CRP or PCT separately. Conclusions IL-6 has a relatively good diagnostic significance on neonatal sepsis. The combination of multi biomarkers should be considered to apply in order to increase the sensitivity of diagnosis for neonatal sepsis.