脐血CRP、PCT、IL-6对新生儿早发型败血症的诊断价值分析

The diagnostic value of cord blood CRP,PCT,and IL-6 for early-onset neonatal sepsis

目的探讨脐血C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)对新生儿早发型败血症(EOS)的诊断价值。方法选取2019年3月—2019年12月赣南医学院第一附属医院产科出生并3 d内转新生儿科收治的168例患儿。根据病情将患儿及其产妇分为EOS组(31例)和对照组(137例)。通过ELISA法测定患儿出生时脐血CRP、PCT、IL-6水平,比较两组以上指标的差异,绘制ROC曲线分析CRP、PCT、IL-6以及三者联合检测的诊断效能。结果两组新生儿性别、胎龄、出生体重比较,差异无统计学意义(P>0.05)。EOS组产妇绒毛膜羊膜炎和胎膜早破比例高于对照组(P<0.05),两组产妇分娩方式比较,差异无统计学意义(P>0.05)。EOS组新生儿脐血CRP、PCT、IL-6水平高于对照组(P<0.05)。CRP、PCT、IL-6均有良好的诊断价值(AUC>0.7)。PCT、IL-6的敏感性(>80%)及特异性(>90%)较高,CRP欠佳。与三者单独诊断比较,CRP+PCT+IL-6联合诊断EOS的AUC及特异性略有提高,但敏感性不如PCT、IL-6。结论脐血CRP、PCT、IL-6对EOS均有较高的诊断价值,选择最合适的指标有助于早期诊断EOS,但3项指标联合检测的意义不大。

Objective To explore the diagnostic value of cord blood C-reactive protein(CRP),procalcitonin(PCT),and interleukin-6(IL-6)for early-onset neonatal sepsis(EOS).Methods One hundred and sixty-eight neonates born in the Department of Obstetrics and transferred to the Department of Neonatology of the First Affiliated Hospital of Gannan Medical University within 3 days after birth between March 2019 and December 2019 were selected.We divided them into the EOS group(31 cases)and the control group(137 cases)according to their conditions.The cord blood CRP,PCT,and IL-6 were measured by enzyme-linked immunosorbent assay(ELISA),and the differences in these indicators between the two groups were compared.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of CRP,PCT,IL-6,and their combined detection for EOS.Results There was no difference in the sex ratio,gestational age or birth weight between the two groups(P>0.05).The proportions of maternal chorioamnionitis and premature rupture of membrane were higher in the EOS group than those in the control group(P<0.05),while the way of delivery was similar between the two groups(P>0.05).The levels of cord blood CRP,PCT,and IL-6 in the EOS group were higher than those in the control group(P<0.05).The areas under the ROC(AUC)curve of cord blood CRP,PCT,and IL-6 were all greater than 0.7,exhibiting high diagnostic values.However,the sensitivity(>80%)and specificity(>90%)of PCT and IL-6 but not CRP were relatively high.Compared with these indicators used alone,the combined detection of CRP,PCT and IL-6 slightly improved the AUC and specificity for diagnosing ESO,whereas the sensitivity was not as high as that of PCT and IL-6.Conclusions Cord blood CRP,PCT,and IL-6 all exhibit high diagnostic values for EOS.Choosing the most suitable indicator helps in early diagnosis of EOS,but the combined detection of the three indicators is of little significance.