不同生物化学指标在预测早产新生儿败血症中的价值

Clinical Value of Different Biochemical Markers in Diagnosing Fetal Sepsis in Premature Neonates

目的比较降钙素原(PCT)、C反应蛋白(CRP)和白细胞介素(IL)-6等3种不同生物化学指标在早期诊断早产新生儿败血症中的应用价值。方法以2010年1月-2012年9月入住且胎膜早破早产新生儿为研究对象,在出生后第1天检测外周血中PCT、CRP和IL-6的滴度,其中有败血症者45例,无败血症者39例。结果败血症组PCT、CRP和IL-6浓度均显著高于非败血症组。PCT和CRP诊断新生儿败血症的临界值分别为2.14μg/L和7.90 mg/L,灵敏度分别为76%和67%,特异度分别为85%和61%;IL-6诊断新生儿败血症的临界值为13.80 ng/L,其灵敏度和特异度则分别高达90%和94%。结论对于胎膜早破新生儿,IL-6是早期诊断败血症较可靠的生物化学指标。

Objective To examine and compare the value of procalcitonin（PCT）, C-reactive protein（CRP） and interleukin（IL）-6 in diagnosing fetal sepsis in premature neonates. Methods Preterm neonates with premature rupture of membrane between January 2010 and September 2012 were screened, and the serum levels of PCT, CRP and IL-6 were detected in the first day of life. All preterm neonates were divided into two groups according to the development of sepsis（45 cases with sepsis and 39 cases without sepsis）. Results The levels of PCT, CRP and IL-6 in premature neonates with sepsis were all significantly higher than those without sepsis. The cut-off value of PCT in diagnosis of sepsis was 2.14 μg/L, with a sensitivity and specificity of 76% and 85% respectively; the cut-off value of CRP in diagnosis of sepsis was 7.90 mg/L, with a sensitivity and specificity of 67% and 61% respectively. For IL-6, the cut-off value in diagnosis of sepsis was 13.80 ng/L, and its sensitivity and specificity were high to 90% and 94%, respectively. Conclusion IL-6 is the most reliable biochemical marker for the detection of early-onset sepsis in preterm neonates with premature rupture of membrane.