血清PCT、TNF-α及sTNFR-Ⅱ在新生儿败血症中表达水平及临床意义

Expression Levels of Serum PCT,TNF-α and sTNFR-Ⅱ in Neonates with Sepsis and Their Clinical Significances

目的探究血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)及可溶性肿瘤坏死因子受体(sTNFR-Ⅱ)在新生儿败血症中表达水平及临床意义。方法选择我院2014年2月至2018年3月收治的84例败血症新生儿纳入败血症组,另择同期于我院接受治疗的41例普通细菌感染患儿纳入感染组;择同期出生、经检查排除任何感染症状的30例健康新生儿作为对照组。比较3组受试者间及败血症患儿治疗前后血清PCT、TNF-α、sTNFR-Ⅱ水平差异,采用ROC曲线分析各指标诊断新生儿败血症的诊断价值。结果与对照组相比,感染组与败血症组均伴有血清PCT、TNF-α、sTNFR-Ⅱ水平的升高,败血症组升高幅度显著高于感染组(P<0.05);治疗后败血症组患儿血清PCT、TNF-α、sTNFR-Ⅱ水平下降,与治疗前各指标水平比较差异具有统计学意义(P<0.05);ROC曲线示血清PCT具有最高的诊断效能,以血清PCT=2. 31ng/mL为最佳截断点,其诊断灵敏度、特异性分别为85.62%、76.89%。结论血清PCT对新生儿败血症具有较高的诊断效能,临床上可作为早期辅助诊断的参考指标。

Objective To investigate the expression levels of serum procalcitonin(PCT),tumor necrosis factor-α(TNF-α)and soluble tumor necrosis factor receptor(sTNFR-II)in neonates with sepsis and their clinical significances.Methods Eighty-four neonates with sepsis who were admitted to the hospital from February,2014 to March,2018 were included in the sepsis group.Another 41 children with common bacterial infection treated in the hospital during the same period were included in the infection group.Thirty healthy neonates without any infection symptoms who were born during the same period were selected as the control group.The levels of serum PCT,TNF-αand sTNFR-II were compared among the three groups.The diagnostic value of each index for neonatal sepsis was analyzed by ROC curve.Results Compared with the control group,the levels of serum PCT,TNF-αand sTNFR-II were increased in the infection group and the sepsis group.The increase in the sepsis group was significantly greater than that in the infected group(P<0.05).The levels of serum PCT,TNF-αand sTNFR-II in the sepsis group were decreased after the treatment(P<0.05).The ROC curve showed that the diagnostic efficiency of serum PCT was the highest.With serum PCT=2.31ng/mL as the best cut-off point,its diagnostic sensitivity and specificity were 85.62%and 76.89%,respectively.Conclusion The diagnostic efficiency of serum PCT is high for neonatal sepsis and it can be used as a reference index for the early diagnosis.