CAL、S100A8、S100A9对新生儿败血症早期诊断及病情判断的临床价值

Clinical value of CAL,S100A8 and S100A9 in the early diagnosis andcondition judgment of neonatal sepsis

目的 探讨血清钙卫蛋白(CAL)、钙结合蛋白A8(S100A8)、钙结合蛋白A9(S100A9)对新生儿败血症早期诊断及病情判断的临床价值。方法 选取2020年2月至2023年2月期间于本院就诊的118例新生儿败血症患儿作为研究对象,根据病情严重程度将其分为轻症组(n=76)和重症组(n=42),另选取同期健康新生儿64例作为对照组。采用酶联免疫吸附法测定各组血清CAL、S100A8和S100A9水平;比较轻、重症新生儿败血症患儿临床资料;Spearman法分析血清CAL、S100A8和S100A9水平与SNAP-Ⅱ评分之间的相关性;多因素Logistic回归分析重症新生儿败血症发生的影响因素;采用受试者工作特征(ROC)曲线分析血清CAL、S100A8和S100A9水平对早期新生儿败血症及病情严重程度的诊断价值。结果 对照组、轻症组、重症组患儿血清CAL、S100A8和S100A9水平递增(F=54.894、64.181、67.572,P<0.05);血清CAL、S100A8和S100A9水平联合诊断新生儿败血症的曲线下面积(AUC)为0.956,敏感度为86.44%;与轻症组相比,重症组患儿SNAP-Ⅱ评分、PCT、CRP水平更高,胎龄更低(t=23.398、6.239、7.783、4.457,P<0.05);血清CAL、S100A8和S100A9水平与SNAP-Ⅱ评分均呈正相关(rs=0.441、0.419、0.452,P<0.001);CAL、S100A8和S100A9为重症新生儿败血症发生的危险因素(OR=2.176、1.654、1.812,P<0.05);血清CAL、S100A8和S100A9水平联合诊断重症新生儿败血症的AUC为0.961,敏感度为95.24%。结论 血清CAL、S100A8和S100A9水平对新生儿败血症早期诊断及病情判断具有较高的临床价值。

Objective To explore the clinical value of serum calprotectin(CAL),calcium-binding protein A8(S100A8),and calcium-binding protein A9(S100A9)in the early diagnosis and condition judgment of neonatal sepsis.Methods 118 cases of neonatal sepsis patients who admitted to our hospital from February 2020 to February 2023 were regarded as the study subjects.According to the severity of condition,they were divided into mild illness group(n=76)and severe illness group(n=42),and another 64 healthy newborns were selected as the control group during the same period.Enzyme-linked immunosorbent assay(ELISA)was applied to measure the levels of serum CAL,S100A8 and S100A9 in each group.The clinical data of neonatal sepsis patients with mild and severe conditions were compared.Spearman s method was applied to analyze the correlation between serum CAL,S100A8 and S100A9 levels and SNAP-Ⅱscores.Multivariate Logistic regression analysis was conducted to identify the influencing factors for the occurrence of severe neonatal sepsis.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum CAL,S100A8 and S100A9 levels in early neonatal sepsis and the severity of the disease.Results Serum levels of CAL,S100A8 and S100A9 in control group,mild illness group and severe illness group were increased(F=54.894,64.181 and 67.572,respectively,P<0.05).Compared with the control group,the serum levels of CAL,S100A8 and S100A9 in children with sepsis were significantly increased(P<0.05),and the serum levels of CAL,S100A8 and S100A9 in the severe group were significantly higher than those in the mild group(P<0.05).The area under the curve(AUC)of the combined diagnosis of serum CAL,S100A8 and S100A9 levels for neonatal sepsis was 0.956,with a sensitivity of 86.44%.Compared with the mild group,patients in the severe group had significantly higher Score for Neonatal Acute PhysiologyⅡ(SNAP-Ⅱscore),procalcitonin(PCT)and C-reactive protein(CRP)levels and significantly lower gestational age(t=23.398,6.239,7.783 and 4.457,respectively,P<0.05).The levels of serum CAL,S100A8 and S100A9 were positively correlated with the SNAP-Ⅱscores(r_(s)=0.441,0.419 and 0.452,respectively,all P<0.001).CAL,S100A8 and S100A9 were identified as risk factors for the occurrence of severe neonatal sepsis(OR=2.176,1.654 and 1.812,respectively,P<0.05).The combined diagnosis of serum CAL,S100A8 and S100A9 levels for_(s)evere neonatal sepsis had an AUC of 0.961,with a sensitivity of 95.24%.Conclusion Serum levels of CAL,S100A8 and S100A9 have high clinical value for the early diagnosis and condition judgment of neonatal sepsis.