补体水平对早产儿早发脓毒症的诊断价值

Diagnostic value of complement level in premature infants with early-onset sepsis

目的研究补体C3、C4对早产儿早发脓毒症的早期识别作用,并分析其对脓毒症合并不同部位感染时的预测价值。方法回顾性分析2022年1月至2022年12月在郑州大学第一附属医院新生儿病房诊治的72例脓毒症患儿及18例正常早产儿的临床资料,分析两组患儿补体水平之间的差异性;将脓毒症组分为脓毒症合并化脑组、脓毒症合并休克组及单纯脓毒症组3个亚组,比较3个亚组与正常对照组之间的补体水平差异性,并应用ROC曲线分析补体水平对3个亚组感染的预测价值。结果脓毒症组与正常对照组之间的补体水平比较差异无统计学意义(P>0.05)。脓毒症合并化脑组补体C3、C4水平均高于正常对照组,差异有统计学意义(P<0.05)。脓毒症合并休克组及单纯脓毒症组补体C3水平均低于正常对照组,组间差异有统计学意义(P<0.05)。脓毒症合并休克组及单纯脓毒症组补体C4水平均低于正常对照组,但差异无统计学意义(P>0.05)。补体水平对脓毒症合并休克及单纯脓毒症的预测价值均较高,对脓毒症合并化脑的预测价值不高。结论脓毒症患儿合并不同部位感染,以及同一感染疾病的不同时期,补体水平均有很大不同。动态检测补体水平变化,可能有助于早产儿脓毒症及其相应并发症的早期诊断及鉴别。

Objective To study the role of complement C3 and C4 in the early identification of premature infants with early-onset sepsis,and to analyze their predictive value for sepsis complicated with different sites of infection.Methods The clinical data of 72 preterm infants with sepsis(sepsis group)and 18 normal preterm infants(control group)were retrospectively analyzed,who were treated in the First Affiliated Hospital of Zhengzhou University from Jan.2022 to Dec.2022.The difference in complement levels between the two groups was analyzed.The sepsis group was divided into three subgroups:sepsis with suppurative meningitis group,sepsis with shock group and simple sepsis group.The differences in complement levels between the three subgroups and the normal control group were compared.ROC curve was used to analyze the predictive value of complement levels for infection in the three subgroups.Results There was no significant difference in complement levels between the sepsis group and the normal control group(P>0.05).The level of complement C3 and C4 in sepsis with suppurative meningitis group was higher than that in control group,and the difference was statistically significant(P<0.05).The levels of complement C3 in the sepsis with shock group and the simple sepsis group were lower than those in the control group,and the differences between the two groups were statistically significant(P<0.05).The levels of complement C4 in the sepsis with shock group and the simple sepsis group were lower than those in the control group,but the difference was not statistically significant(P>0.05).The predictive value of complement level for sepsis combined with shock and sepsis alone was high,but the predictive value for sepsis combined with suppurative meningitis was not high.Conclusion Complement levels are significantly different in children with sepsis complicated with different sites of infection or at different stages of the same infection.Dynamic detection of complement levels may be helpful for the early diagnosis and differential diagnosis of sepsis and its corresponding complications in preterm infants.