可溶性髓样细胞触发受体1、脂多糖连接蛋白在新生儿严重细菌感染诊断中的价值

The diagnostic value of soluble triggering receptor expressed on myeloid cells-1 and lipopolysaccharide binding protein in neonatal serious bacterial infections

目的探讨可溶性髓样细胞触发受体1(sTREM-1)、脂多糖连接蛋白(LBP)在诊断新生儿严重细菌感染中的价值。方法共171例新生儿纳入研究,根据临床表现、实验室检查和发病时间分为感染组(包括早发感染和晚发感染)及非感染组;检测两组新生儿血清sTREM-1、LBP、CRP水平,并绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),评估各项指标对新生儿严重细菌感染的诊断价值。结果感染组新生儿sTREM-1、LBP水平明显升高,与非感染组的差异有统计学意义(P=0.000)。在诊断新生儿早发严重感染中,sTREM-1的AUC(0.888)最高,LBP(0.839)次之,CRP(0.706)最低;而在诊断新生儿晚发严重感染中,LBP的AUC(0.865)最高,sTREM-1(0.860)次之,CRP(0.705)最低。结论 sTREM-1、LBP在新生儿严重细菌感染诊断中具有一定价值。

Objective To evaluate the accuracy of the soluble triggering receptor expressed on myeloid cells-1 （sTREM-1） and lipopolysaccharide binding protein （LBP） as diagnostic indices for neonatal serious bacterial infections （SBI）. Methods A total of 171 newborns were enrolled in the study, and were classified into SBI group （including early-onset and late-onset）, non-SBI group according to clinical manifestations, laboratory examinations and the time of disease onset. Serum sTREM-1, LBP and C-reactive protein （CRP） levels were measured. Receiver operator characteristic curve （ROC） was drawn, and the area under curve （AUC） was calculated. Each index was evaluated for the diagnostic value of neonatal SBI. Results The sTREM-1 and LBP levels were significantly higher in SBI group than those in non-SBI group （P=0.000）. The AUC of ROC for sTREM-1, LBP and CRP in early-onset SBI was 0.888, 0.839 and 0.706, respectively. The AUC of ROC for sTREM-1, LBP and CRP in late-onset SBI was 0.860, 0.865 and 0.705, respectively. Conclusions Both sTREM-1 and LBP are useful for the diag-nosis of neonatal SBI.