联合测定免疫球蛋白M和高敏C反应蛋白对新生儿败血症的早期诊断意义

Significance of Detection of Serum Immunoglobulin M Combined With High Sensitivity C-Reactive Protein in Early Diagnosis of Neonatal Septicemia

目的探讨血清免疫球蛋白(serum immunoglobulin,Ig)M和高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)联合测定在新生儿败血症早期诊断中的意义。方法选择2006年1月至2009年1月,本院新生儿科收治的32例新生儿败血症患儿(胎龄为37～41孕周)纳入败血症组。随机抽取同期本院新生儿科收治的临床无感染征象足月新生儿29例纳入对照组(本研究遵循的程序符合本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,分组征得试验患儿监护人的知情同意,并与其签署临床研究知情同意书)。两组患儿胎龄、出生体重、头围和身长比较,差异无显著意义(P>0.05)。采用BACTEC9050血培养仪,观察细菌生长结果和采用比浊法分别测定两组患儿血清免疫球蛋白M和高敏C反应蛋白的水平。结果败血症组治疗前,血清免疫球蛋白M和高敏C反应蛋白水平分别与对照组比较[(0.56±0.11)g/L和(43.80±6.12)mg/Lvs.(0.26±0.13)g/L和(8.35±2.39)mg/L],差异有显著意义(P<0.05)。败血症组治疗后,血清中免疫球蛋白M和高敏C反应蛋白水平分别与治疗前比较[(0.69±0.13)g/L和(7.59±4.44)mg/Lvs.(0.56±0.11)g/L和(43.80±6.12)mg/L],差异有显著意义(P<0.05)。结论联合测定血清免疫球蛋白M与高敏C反应蛋白水平,对早期诊断新生儿败血症有一定的临床价值。

Objective To evaluate the clinical significance of detection of serum immunoglobulin M （IgM） combined with high sensitivity C reactive protein （hs CRP）in neonates with septicemia. Methods From January 2006 to January 2009, 32 neonates with septicemia （gestational age of 37 41 weeks） were selected as septicemia group. Another 25 full term neonates without bacterial infection were selected as control group. Informed consent was obtained from all participants. There had no significant differences of gestational week, birth weight, head circumference, and body length between two groups （P〉0.05）. The results of bacterial growth were observed by BACTEC 9050 blood culture system, and the level of immunoglobulin M and C-reactive protein were detected by nephelometry in two groups. Results There had significant differences of the level of serum immunoglobulin M and high sensitivity C reactive protein between pre-therapy of septicemia group and control group [（0.56±0. 11） g/L and （43.80±6. 12） mg/L vs. （0.26±0.13） g/L and （8.35±2.39） mg/L] （P〈0.05）. There had significant differences of the level of serum immunoglobulin M and high sensitivity C reactive protein before and after the treatment of septicemia group [（0. 69±0. 13） g/L and （7. 59±4. 44） mg/L vs. （0. 56±0. 11） g/L and （43. 80± 6.12） mg/L 2 （P 〈 0. 05）. Conclusion The combined assay of serum immunoglobulin M and high sensitivity C reactive protein are valuable for the early diagnosis of neonatal septicemia.