血清降钙素原及白细胞介素6水平在新生儿败血症早期诊断中的临床价值

Clinical Value of Serum Levels of Procalcitonin and Interleukin-6 in Early Diagnosis of Neonatal Sepsis

目的研究血清降钙素原(PCT)及白细胞介素6(IL-6)水平在新生儿败血症早期诊断中的临床价值。方法将2011年1月至2012年12月期间在高州市人民医院就诊的100例新生儿败血症患者纳入败血症组,同期分娩的100例健康新生儿纳入健康组,采集外周血检测PCT及IL-6水平,并通过序贯器官功能衰竭评估(SOFA)评分、小儿危重评分病例评分(PCIS)判断全身情况。结果与健康组比较,败血症组患儿PCT、IL-6水平及SOFA评分均高于健康组[(13.8±2.5)μg/L vs(2.8±0.1)μg/L,(272.9±43.6)ng/L vs(58.5±8.2)ng/L,(8.8±1.3)分vs(2.3±0.5)分],PCIS评分低于健康组[(72.1±11.4)分vs(95.8±13.1)分],差异均有统计学意义(P<0.05);SOFA评分与PCT、IL-6水平呈正相关(P<0.05),PCIS评分与PCT、IL-6水平呈负相关(P<0.05);PCT、IL-6两项指标联合检查灵敏度为94%、特异度为96%,均高于两项指标单独检测。结论新生儿败血症患者的PCT及IL-6水平明显升高,且与疾病的严重程度密切相关,两项指标联合检测可提高敏感性和特异性。

Objective To study the clinical value of serum levels of procalcitonin （PCT） and interleu- kin-6（IL-6） in early diagnosis of neonatal sepsis. Methods A total of 100 patients with neonatal sepsis admitted in Gaozhou City People＇ Hospital from Jan. 2011 to Dec. 2012 were enrolled in the septicemia group and another 100 cases of newborn infants during the same period were enrolled in the healthy group. Then serum PCT and IL-6 levels were detected from peripheral blood, and the general condition were judged by sequential organ failure assessment （SOFA） score and pediatric critical illness score （PCIS）. Results PCT, IL-6 levels and SOFA score of septicemia group were higher than those of healthy group [ （ 13.8±2.5 ） μg/L vs （2.8 ±0.1） wg/L,（272.9±43.6） ng/L vs （58.5±8.2） rig/L,（8.8±1.3） vs （2.3±0.5） score] （ P 〈 0.05 ）. PCIS of septicemia group was lower than healthy group [ （72.1±11.4 ） vs （ 95.8 ±13.1 ） ] （ P 〈 0.05 ）. SOFA score were positively correlated with PCT, IL-6 levels, PCIS score was negatively correlated with PCT, IL-6 levels （ P 〈 0.05 ） ; sensitivity and specificity of PCT, IL-6 joint detection was respectively 94% and 96%, which was higher than that of the single detection （P 〈 0.05 ）. Conclusion PCT, IL-6 levels of patients with neonatal sepsis significantly increase and are closely related to the severity of disease ,joint detection of the two indexes can improve the sensitivity and specificity