降钙素原、C-反应蛋白及IL-6在早产胎膜早破新生儿败血症中的诊断价值

Diagnostic value of Procalcitonin,CRP and IL-6 in fetal sepsis with Preterm Premature Rupture of Membranes

目的探讨C-反应蛋白(CRP)和降钙素原(PCT)和IL-6在早期诊断胎膜早破新生儿败血症的应用价值。方法选取56例胎膜早破新生儿为研究对象,其中新生儿败血症30例,正常婴儿26例。在出生后第1天,获取静脉血检测IL-6,CRP和PCT的浓度,3 d后重复检测CRP和PCT。结果新生儿出生第1天,IL-6、CRP和PCT在败血症组中的浓度显著高于非败血症组。3 d后,败血症患儿PCT明显高于正常组,而CRP在两组当中无统计学意义。CRP和PCT在第1天诊断新生儿感染的临界值分别为7.3 mg/L和1.75μg/L,敏感性和特异性分别为57%和59%,78%和86%。第3天,CRP和PCT的临界值为7.7 mg/L和1.81μg/L,敏感性和特异性分别为和61%和66%,90%和88%。而对于IL-6,1 d时临界值为7.9 ng/L,其敏感性和特异性分别为94%和97%。结论对于胎膜早破败血症患儿,IL-6具有最高的敏感性和特异性,而PCT的敏感性略优于CRP。

Objective To examine the diagnosis value of C-reactive protein （CRP）, procalcitonin （PCT） and IL-6 in fetal sep sis who were born after preterm premature rupture of membranes. Methods 56 preterm neonates were divided into two groups according to the development of sepsis （sepsis of 30 cases, normal of 26 cases）. IL-6, CRP and PCT levels were measured in the 1st day of life, and at 3rd day, CRP and PCT were repeated. Results There were significant differences between the two groups in the 1st day IL-6, CRP and PCT, PCT levels on 3rd day. CRP levels were not significantly different between the two groups on the 3rd day of life. CRP and PCT levels on the 1st day of life had a cut-off value of 7.3 mg/L with a sensitiv- ity and specificity of 57% and 59%, 1.75 txg/L with a sensitivity and specificity of 78% and 86%, respectively. CRP levels on the 3rd day had a cut-off level of 7.7 mg/L with 61% sensitivity and 66% specificity, and PCT levels had a cut-off level of 1.81 txg/L with 90% sensitivity and 88% specificity. For a cut-off value of 7.9 ng/L of IL-6, the sensitivity and specificity were 94% and 97% in the 1st day, respectively. Conclusion IL-6 is the most reliable marker for the detection of early-on- set sepsis in preterm neonates with PPROM, and PCT levels is seemed to be more sensitive than CRP in this population.