血清白细胞介素-8与C-反应蛋白对新生儿细菌感染诊治的应用研究

Effect of serum interleukin-8 combined with C-reactive protein in diagnosis and treatment of bacterial infections in neonates

目的探讨血清白细胞介素-8(IL-8)与C-反应蛋白(CRP)测定对新生儿细菌感染诊治效果,从而提高新生儿细菌感染检测和治疗的科学性。方法选择2013年6月-2014年11月医院出生的100例新生儿为研究对象,将临床确诊细菌感染新生儿52例为观察组,临床疑似细菌感染新生儿48例为对照组;对两组新生儿进行血常规、血培养和IL-8+CRP检测,并对其给予抗菌药物临床治疗,视实际病情待新生儿痊愈后再次进行上述指标检测,观察两组新生儿检测指标阴性与阳性例数和IL-8联合CRP预测新生儿感染情况,并比较新生儿治疗前后IL-8、CRP水平差异;采用SPSS13.0软件对数据进行统计分析。结果观察组在血常规、血培养和IL-8+CRP检测阳性例数均高于对照组,其中IL-8+CRP检测阳性例数最多,高于对照组26例,差异有统计学意义(P<0.05);发现采用IL-8联合CRP预测新生儿感染阴性预测率为98.93%,预测率明显高于单一采用IL-8或CRP,差异有统计学意义(P<0.05);两组新生儿治疗后IL-8、CRP水平较治疗前均明显下降,降为正常水平,差异有统计学意义(P<0.05)。结论综合运用血清IL-8联合CRP测定在新生儿细菌感染检测中能够提高检测准确度和精度,避免误诊、漏诊,且抗菌药物使用以IL-8≥80ng/L或CRP≥10mg/L临界值最佳。

OBJECTIVE To explore the effect of serum interleukin-8（IL-8）combined with C-reactive protein（CRP）in the diagnosis and treatment of bacterial infections in neonates so as to provide scientific basis for detection of treatment of the neonates with the bacterial infections.METHODS A total of 100 neonates who were born from Jun 2013 to Nov 2014 were recruited as the study objects,then 52 neonates with clinically confirmed bacterial infections were assigned as the observation group,and 48 neonates with clinically suspected bacterial infections were set as the control group.The blood routines examination,blood culture,and detection of IL-8plus CRP were carried out for the two groups of neonates,the neonates were given the clinical antibiotic therapy,and the above indicators were detected once again based on the actual illness condition after the neonates were cured.The negative test indicators and the number of positive cases were observed,the detection of the IL-8combined with CRP in prediction of the neonatal infections was studied,and the levels of IL-8and CRP of the neonates were observed and compared before and after the treatment;the statistical analysis of data was performed with the use of SPSS13.0software.RESULTS The number of cases that were positive for the blood routines,blood culture,and detection of IL-8combined with CRP was larger in the observation group than in the control group,and the number of cases positive for the detection of IL-8combined with CRP was the largest,26 cases in the control group,and there was significant difference（P〈0.05）.The negative predictive value of the detection of IL-8combined with CRP was98.93%in the prediction of the neonatal infections,significantly higher than that of the single detection of IL-8or CRP（P〈0.05）.The levels of IL-8and CRP of the two groups of neonates significently declined after the treatment,dropping down to the normal levels（P〈0.05）.CONCLUSION The detection of serum IL-8combined with CRP can raise the accuracy and precision of the diagnosis of the bacterial infections in the neonates and avoid the misdiagnosis and missed diagnosis.The IL-8level no less than 80ng/L or the CRP level no less than 10mg/L is the optimal critical value for the use of antibiotics.