早期诊断标志物白细胞介素6与C反应蛋白在新生儿感染的价值比较研究

Comparative study on the value of interleukin 6 and C reactive protein as early diagnosis markers of neonatal infection

目的比较IL-6与CRP在早期诊断新生儿感染尤其是新生儿败血症的价值预后评估的意义,以及早发现发生感染的高危患儿。方法在2009年1月-2012年12月的80例新生儿细菌性败血症患儿,另设立非败血症对照组80例。入院后在使用抗生素前对病例组及对照组送检CRP、IL-6、血常规及血培养,在使用抗生素后4h、24h复查CRP、IL-6。结果 1)败血症组在使用抗生素后4h的IL-6显著增加达到高峰;在使用抗生素后24h的CRP达到高峰。2)在早产儿败血症和足月儿败血症组,IL-6在发病后4h时的诊断的敏感性和特异性均明显高于CRP。结论 IL-6在早期诊断新生儿败血症上具有较高的敏感性、特异性,在感染后4h监测血IL-6水平最敏感,而CRP在感染后24h最敏感,炎性分子IL-6的异常增高早于CRP的异常增高。

Objective To compare the significance of IL-6and C reactive protein（CRP）in early diagnosis and prognosis of neonatal sepsis,and to timely detect neonates in high-risk of infection. Methods A total of 80 neonatal sepsis patients from January 2009 to December 2012 in NICU who met the criteria were included,and 80 cases of non-sepsis were set as the control group.After admission,blood was collected before use of antibiotics,and then submitted for CRP,IL-6detection,blood routine examination and blood culture.The CRP and IL-6were reviewed at 4h,24 hafter the use of antibiotics for patient in the case group and control group. Results 1）There were significant differences（P〈0.05）between the sepsis group and the control group for the IL-6and CRP.After 4hof the antibiotics usage,IL-6increased significantly to a peak;whereas CRP peaked at 24 hafter the antibiotics usage.2）In premature and full-term neonates group,the diagnosis sensitivity and specificity of IL-6were significantly higher than CRP after 4hof the antibiotics usage. Conclusions IL-6has a high sensitivity and specificity for the early diagnosis of neonatal sepsis.IL-6monitoring at 4hafter infection is most sensitive,and CRP is most sensitive at 24 hafter infection.Abnormally high levels of IL-6increased early than CRP.