sTREM-1、CRP对新生儿败血症早期诊断及疗效判断的价值研究

Study on the value of sTREM-1 and CRP in early diagnosis and therapeutic evaluation of neonatal sepsis

目的探讨血清可溶性髓系细胞触发受体-1(sTREM-1)、C-反应蛋白(CRP)在新生儿败血症早期诊断及疗效判断上的作用。方法选取足月新生儿120例为研究对象,分确诊败血症组(确诊组)20例、临床诊断败血症组(临床诊断组)35例及非败血症组(对照组)65例。比较确诊组、临床诊断组和对照组新生儿之间的血清sTREM-1及CRP的差异,比较败血症组(确诊组+临床诊断组)和对照组2、6、72 h新生儿血清sTREM-1及CRP的差异。结果确诊组、临床诊断组新生儿血清sTREM-1和CRP水平均明显高于对照组,差异有统计学意义(P<0.05)。败血症组血清sTREM-1在发病第2 h开始升高,6 h达高峰期,有效治疗后于72 h逐渐恢复正常;血清CRP在发病第2 h无明显变化,6 h开始升高,有效治疗后于72 h逐渐下降。结论 sTREM-1、CRP参与炎症反应,且两者水平与感染严重程度相关,sTREM-1早期诊断新生儿败血症及疗效判断的价值高于CRP。

Objective To explore the roles of serum soluble triggering receptors expressed on myeloid cells 1（ sTREM-1） and C-reactive protein（ CRP） in early diagnosis and therapeutic evaluation of neonatal sepsis.Methods A total of 120 full-term neonates were selected and divided into sepsis definite diagnosis group（ 20 neonates）,sepsis clinical diagnosis group（ 35 neonates）,and non-sepsis group（ control group,65 neonates）.The differences of serum sTREM-1 and CRP levels were compared among sepsis definite diagnosis group,sepsis clinical diagnosis group,and control group.The differences of serum sTREM-1 and CRP levels after 2,6,and 72 hours were compared between sepsis group（ sepsis definite diagnosis group and sepsis clinical diagnosis group） and control group.Results The levels of serum sTREM-1 and CRP in sepsis definite diagnosis group and sepsis clinical diagnosis group were statistically significantly higher than those in control group（ P〈0.05）.The level of serum sTREM-1 in sepsis group increased from the second hour,peaked at the sixth hour,and returned to normal level at 72 hours after effective treatment;serum CRP level didn’t change significantly at the second hour,increased from the sixth hour,and returned to normal level at 72 hours after effective treatment.Conclusion sTREM-1 and CRP participate in inflammatory response,which are associated with the severity of infection.The value of sTREM-1 in early diagnosis and therapeutic evaluation of neonatal sepsis is superior to CRP.