血清锌检测对新生儿败血症的诊断价值及临床意义

Clinical significance and diagnostic value of serum zinc detection in neonatal sepsis

目的评估新生儿败血症患儿的血清锌水平,探讨其对新生儿败血症的诊断价值。方法采用前瞻性观察研究,纳入新生儿败血症的患儿52例作为研究组,同时期我院产科出生的健康新生儿50例作为对照组。检测新生儿血清锌水平,比较2组间的血清锌水平和炎性指标水平。结果2组一般资料差异无统计学意义(P>0.05)。研究组血清锌平均水平(52.6±17.4)μg/dL显著低于对照组(83.2±21.4)μg/dL(P<0.05);早发型败血症(EOS)组血清锌平均水平(50.8±13.2)μg/dL与晚发型败血症(LOS)组血清平均水平(53.4±14.4)μg/dL相比较,差异无统计学意义(P>0.05)。研究组中患儿白细胞计数、淋巴细胞计数、中性粒细胞计数、C反应蛋白(CRP)均显著高于对照组,差异有统计学意义(P<0.05),研究组中患儿血清锌水平与淋巴细胞计数呈显著正相关(r=0.537,P<0.05),而与中性粒细胞计数呈显著负相关(r=-0.544,P<0.05)。通过受试者工作特征曲线(ROC)分析,血清锌预测新生儿败血症的ROC曲线下面积(AUC)是0.812(P<0.05),与CRP(AUC=0.865,P<0.05)相比较低,但仍具有预测诊断的价值,其灵敏度为78%,特异度为76.9%。结论血清锌水平与新生儿败血症存在相关性,新生儿败血症患儿体内存在更高的炎症反应,血清锌的检测对新生儿败血症具有预测价值。

Objective To evaluate the serum zinc levels in children with neonatal sepsis and explore the diagnostic value of neonatal septicemia.Methods A prospective investigation was carried out,with 52 cases of neonatal sepsis as the study group and 50 cases of healthy newborns as the control group.The enzyme-linked immunosorbent assay(ELISA)was used to monitor the levels of serum zinc of infants.The average level of serum zinc were compared between the two groups.Results There was no significant difference in general data between the tnog roups(P>0.05).The average level of serum zinc was(52.6±17.4)μg/dL,which was significantly lower than(83.2±21.4)μg/dL in the control group(P<0.05).There was no significant difference in serum zinc between the early onset sepsis(EOS)group(50.8±13.2)μg/dL and the late onset sepsis(LOS)group(53.4±14.4)μg/dL(P>0.05).The percentage of leukocyte count,lymphocyte count,neutrophil count,and C-reactive protein in the group of neonatal sepsis were significantly higher than those in the control group(P<0.05).The level of serum zinc level was positively correlated with lymphocyte count(r=0.537,P<0.05)and was negative correlation with neutrophil count(r=0.544,P<0.05)in septicemia group.The area under ROC curve to predict neonatal sepsis was 0.812(P<0.05),which was weaker than CRP(AUC=0.865,P<0.05),but it was still valuable in predicting diagnosis,with a sensitivity of 78%and a specificity of 76.9%.Conclusion Abnormal inflammatory response exists in neonates with serum zinc deficiency,which is related to the occurrence of neonatal sepsis.Serum zinc detection is valuable in prediction of neonatal sepsis.