新生儿败血症及败血症休克时血清IL-6、IL-6mRNA表达水平的研究

A study on the levels of IL-6 and IL-6mRNA expression in neonates with septicemia and septic shock

为探讨血清IL_6水平变化在新生儿败血症中的意义 ,采用酶联免疫吸附法 (ELISA)检测正常与严重感染新生儿血清IL_6值 ,用逆转录聚合酶链反应 (RT_PCR)技术测定外周血单个核细胞 (PBMC)IL_6mRNA表达情况。结果 :血清IL_6水平以败血症休克组最高 ,败血症组次之 ,恢复期迅速下降 ;检测5例败血症新生儿PBMC均见IL_6mRNA表达 ,而6例对照新生儿中仅3例有IL_6mRNA表达 ;按百分位数法初步确定血清IL_6≥23ng/L为诊断新生儿败血症的参考指标 ,此指标敏感性为81% ,特异性为83 %。提示新生儿败血症及败血症休克早期血清IL_6水平升高、IL_6mRNA表达增强 ,与病情、预后有关 。

To explore the clinical significance of the change in serum IL-6 level and IL-6mRNA expression of peripheral blood monomuclear cell(PBMC)in newborn infants with different bacterial infections,serum IL-6 level was determined by means of ELISA in a group of neonatal septicemia(38 cases),a group of septic shock(21 cases)and normal control group(20 healthy neonates)in this study.Also,the level of IL-6mRNA expression in PBMC was detected with the method of reverse transcription PCR.The results showed that serum IL-6 level in group of neonatal septicemia was significantly higher than that of normal controls,and this level of group with septic shock showed highest among these 3 groups.Sifnificantly,serum IL-6 level was discovered to rapidly fall down during the recovery stage of the infection.It was identified that the optimal cut-off point of diagnostic reference value was obtained with percentile mode should be 23ng/L or more with the sensitivity of 81% and the specificity of 83%.Moreover,IL-6mRNA in PBMC of 5 infected cases determined was found to have a quite complete expression level and ,otherwise,only 3 of 6 healthy neonates determined got a weak expression of IL-6mRNA in PBMC.Through this study,the conclusion is that the determination of the change in serum IL-6 level in early stage of neonates with bacterial infections,especially neonatal sepsis,might be evidently associated with the the disease severity and the outcome of the illness and,therefore,this detection might be looked as anearly indicator for neonatal beacterial infections in clinical practice.