新生儿败血症T淋巴细胞亚群、PCT、CRP、Lac及炎症因子的检测及其临床意义

Detection of T lymphocyte subsets,PCT,CRP,Lac,and inflammatory factors in neonates with sepsis and its clinical significance

目的检测新生儿败血症T淋巴细胞亚群(CD3、CD4、CD8)、降钙素原(PCT)、C反应蛋白(CRP)、乳酸(Lac)及炎症因子[白介素-6(IL-6)、白介素-8(IL-8)]水平并探讨其临床意义。方法选取2017年6月至2019年6月陕西中医药大学第二附属医院收治的58例新生儿败血症作为研究组,选择在本院分娩且健康的58例无感染的新生儿作为对照组。检测研究组新生儿治疗前后以及对照组新生儿的T淋巴细胞亚群、PCT、CRP、Lac及炎症因子。分析并比较研究组新生儿治疗前后与对照组新生儿的T淋巴细胞亚群、PCT、CRP、Lac及炎症因子的水平。结果研究组新生儿治疗前的CD3和CD4水平分别为(46.3±12.2)%、(33.1±10.3)%,明显低于对照组的(62.3±11.97)%、(46.4±11.98)%,差异均有统计学意义(P<0.05);研究组新生儿治疗后的T淋巴细胞亚群CD3和CD4水平分别为(61.5±10.9)%、(45.4±10.6)%,与对照组比较差异均无统计学意义(P>0.05);研究组新生儿治疗后的T淋巴细胞亚群CD3和CD4水平与治疗前比较差异有统计学意义(P<0.05);研究组新生儿治疗前后的CD8水平分别为(12.1±4.28)%、(13.1±3.98)%,与对照组的(12.55±5.38)%比较差异均无统计学意义(P>0.05);治疗前,研究组和对照组新生儿的PCT[(24.3±3.2)μg/L vs(0.5±0.1)μg/L]、CRP[(36.1±10.9)mg/L vs(4.4±0.98)mg/L]、Lac[(1.41±0.98)mmol/L vs(0.55±0.38)mmol/L]、IL-6[(234.3±38.2)ng/L vs(55.5±10.1)ng/L]、IL-8[(270.1±40.9)ng/L vs(49.4±11.98)ng/L]比较,研究组明显高于对照组,差异均有统计学意义(P<0.05);研究组新生儿治疗后的PCT水平为(0.58±0.3)μg/L,与对照组比较差异无统计学意义(P>0.05);治疗后,研究组和对照组新生儿的CRP[(10.4±3.6)mg/L vs(4.4±0.98)mg/L]、Lac[(0.88±0.98)mmol/L vs(0.55±0.38)mmol/L]、IL-6[(90.58±20.3)ng/L vs(55.5±10.1)ng/L]、IL-8[(86.4±23.6)ng/L vs(49.4±11.98)ng/L]比较,研究组仍明显高于对照组,差异均有统计学意义(P<0.05);研究组新生儿治疗后的PCT、CRP、Lac、IL-6、IL-8水平与治疗前比较差异均有统计学意义(P<0.05)。结论T淋巴细胞亚群、PCT、CRP、Lac及炎症因子检测能及时指导医生采取有效的治疗措施,提高新生儿败血症成功救治率,值得临床推广应用。

Objective To investigate the clinical significance of T lymphocyte subsets(CD3,CD4,CD8),procalcitonin(PCT),C-reactive protein(CRP),lactic acid(Lac),and inflammatory factors(interleukin-6[IL-6],interleukin-8[IL-8])in neonates with sepsis.Methods Fifty-eight neonates of sepsis admitted to the Second Affiliated Hospital of Shaanxi University of traditional Chinese medicine from June 2017 to June 2019 were selected as the study group,and 58 healthy newborns without infection in the hospital were selected as the control group.T lymphocyte subsets,PCT,CRP,Lac,and inflammatory factors were detected before and after treatment in the study group and in the control group.The levels of T lymphocyte subsets,PCT,CRP,Lac,and inflammatory factors were analyzed and compared between the two groups before and after treatment.Results Before treatment,the levels of CD3 and CD4 of neonates in the study group were(46.3±12.2)%and(33.1±10.3)%,which were significantly lower than(62.3±11.97)%and(46.4±11.98)%in the control group(P<0.05);after treatment,the levels of CD3 and CD4 of neonates in the study group were(61.5±10.9)%and(45.4±10.6)%,respectively,which were not significantly different as compared with(62.3±11.97)%and(46.4±11.98)%in the control group(P<0.05).The levels of T lymphocyte subsets CD3 and CD4 in the study group after treatment were significantly different from those before treatment(P<0.05).The CD8 levels of the study group before and after treatment were(12.1±4.28)%,(13.1±3.98)%,which showed no significant difference with(12.55±5.38)%in the control group(P>0.05).Before treatment,PCT CRP,Lac,IL-6,IL-8 of neonates were significantly higher in the study group than in the control group(P<0.05):PCT,(24.3±3.2)μg/L vs(0.5±0.1)μg/L;CRP,(36.1±10.9)mg/L vs(4.4±0.98)mg/L;Lac,(1.41±0.98)mmol/L vs(0.55±0.38)mmol/L;IL-6,(234.3±38.2)ng/L vs(55.5±10.1)ng/L;IL-8,(270.1±40.9)ng/L vs(49.4±11.98)ng/L;after treatment,the PCT level of neonates in the study group showed no significant difference with that in the control group:(0.58±0.3)μg/L vs(0.5±0.1)μg/L(P>0.05);after treatment,neonatal CRP,Lac,IL-6,and IL-8 in the study group were significantly higher than those in the control group(P<0.05):CRP,(10.4±3.6)mg/L vs(4.4±0.98)mg/L;Lac,(0.88±0.98)mmol/L vs(0.55±0.38)mmol/L;IL-6,(90.58±20.3)ng/L vs(55.5±10.1)ng/L;IL-8,(86.4±23.6)ng/L vs(49.4±11.98)ng/L.PCT,CRP,Lac,IL-6,IL-8 levels of the study group after treatment were significantly different from those before treatment(P<0.05).Conclusion The detection of T lymphocyte subsets,PCT,CRP,Lac,and inflammatory factors can timely guide doctors to take effective treatment measures and improve the successful treatment rate of neonatal sepsis,which is worthy of clinical application.