血液氨基酸和酰基肉碱水平对新生儿晚发型败血症的评估分析

Evaluation of Blood Amino Acids and Acyl Carnitine Levels in Neonatal Late-Onset Sepsis

目的比较新生儿晚发型败血症的血氨基酸和酰基肉碱水平与正常新生儿的变化及其意义。方法选取2019年6月至2020年5月我院治疗的新生儿晚发型败血症患儿共116例,同时选取同期健康新生儿127例作为对照组。根据危重症评分,将患儿分为非危重组75例(≤90分)和危重组41例(>90分),比较三组的血液氨基酸和酰基肉碱水平。结果危重组新生儿WBC、PLT、前白蛋白水平与非危重组与对照组比较差异有统计意义,危重组中颅脑感染明显增高。危重组丙氨酸、亮氨酸、缬氨酸水平明显降低,酪氨酸、苯丙氨酸、蛋氨酸水平明显升高。非危重组与对照组比较,仅酪氨酸水平明显升高。酰基肉碱分析比较中,危重组癸酰基肉碱、十六烷酰基肉碱水平明显增高,游离肉碱水平明显降低。非危重组与对照组比较,仅游离肉碱水平明显降低。游离肉碱、蛋氨酸、酪氨酸、苯丙氨酸,这4项指标的AUC均在0.7以上,具有一定的预测价值。结论新生儿血液氨基酸和酰基肉碱水平与新生儿晚发型败血症相关,可对新生儿晚发型败血症的严重程度进行预测。

Objective To compare the changes of blood amino acid and acyl carnitine levels innewbornswith late onset neonatal sepsis and normal term infants.Methods We selected 116 late onset neonatal sepsis newborns in our hospital from June2019 to May 2020.The patients were divided into non risk group(>90 scores) and risk group(≤90 scores).127 healthy term infants were selected as the control group.The electronic medical records of children with late-onset sepsis were retrospectively analyzed,and the levels of blood amino acids and acyl carnitine were compared among the three groups.Results The levels of WBC,PLT and proalbumin in the critically ill group were statistically different from those in the non-critically ill group and the control group,and the level of middle craniocerebral infection in the critically ill group was significantly increased.The levels of alanine,leucine and valine were significantly decreased,and the levels of tyrosine,phenylalanine and methionine were significantly increased in the critical group. Compared with the control group,only tyrosine level was significantly increased in the non-critical group.In the analysis of acylcarnitine,decacylcarnitine and hexadecylcarnitine levels in the critical group were significantly increased,while the free carnitine levels were significantly decreased.Compared with the control group,only free carnitine level was significantly decreased in non risk group.The AUC of free carnitine,methionine,tyrosine and phenylalanine were all above 0. 7,which had important value in predicting the disease.Conclusion The levels of amino acids and acyl carnitine are correlated with neonatal late-onset sepsis,which can be used to predict the severity of neonatal late-onset sepsis.