血清趋化因子RANTES对新生儿早期感染诊断价值

Diagnostic value of serum chemokine RANTES in the early neonatal infection

目的探究新生儿发生早期感染外周血趋化因子T细胞正常表达和分泌刺激因子(Regulation on activation normal T-cell expressed and secreted,RANTES)的表达及临床意义。方法选择孝感市第一人民医院产科2017年5月-2019年5月发生细菌及病毒感染的新生儿75例作为感染组,另选择同期未发生感染的新生儿75例作为非感染组。对感染组新生儿不同标本中的病原进行分离鉴定。采用双夹心抗体酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)检测血清RANTES浓度。结果感染组新生儿血清RANTES浓度为(69.28±29.31)μg/ml,高于非感染组的(14.38±6.29)μg/ml,差异具有统计学意义(P<0.05)。感染组早产儿、非早产儿血清RANTES浓度均高于非感染组(P<0.05)。细菌感染、病毒感染新生儿血清RANTES浓度均高于非感染组(P<0.05)。全身感染、局部感染新生儿血清RANTES浓度均高于非感染组(P<0.05)。全身感染新生儿血清RANTES浓度高于局部感染,差异具有统计学意义(P<0.05)。ROC分析结果表明,血清RANTES水平对于早产儿、非早产儿、细菌感染、病毒感染、局部感染、全身感染等感染发生均具有良好的诊断价值。结论血清RANTES水平在不同病原感染类型及不同感染部位与非感染组之间存在明显差异,对于新生儿早期感染具有良好的诊断价值。

OBJECTIVE To investigate the expression and clinical significance of Regulation on activation normal T-cell expressed and secreted(RANTES)in the early neonatal infection.METHODS From May 2017 to May 2019,75 cases of neonates with bacterial and viral infections in the Department of Obstetrics and Gynecology,First People’s Hospital of Xiaogan City were recruited in the infection group.Seventy-five cases of neonates who had not infected during the same period were enrolled in the un-infected group.The pathogens in specimens of newborns of the infected group were isolated and identified.Serum RANTES concentration was measured by double sandwich antibody ELISA.RESULTS The concentrations of serum RANTES in the neonates of the infected and non-infected groups were(69.28±29.31)and(14.38±6.29)μg/ml,respectively,and the differences between them were significant(P<0.05).The serum RANTES concentration in the preterm and non-preterm infants of the infected group was significantly higher than that of the non-infected group(P<0.05).The serum RANTES concentration in the newborns with bacterial and virus infection was significantly higher than that in the non-infected group(P<0.05).There were no significant differences in serum RANTES concentration between bacterial infection and viral infection.The serum RANTES concentration in the neonates with systemic infection and local infection were significantly higher than that in the non-infected group(P<0.05).The serum RANTES concentration in neonates with systemic infection was significantly higher than that with local infection(P<0.05).The results of ROC analysis showed that serum RANTES level had diagnostic value for the occurrence of premature,non-premature,bacterial,viral,local and systemic infections(P<0.05).CONCLUSION Serum RANTES level was significantly changed according to the infection,types of pathogen infected and infection sites.It may have diagnostic value for the early neonatal infections and worth of clinical promotion.