aEEG及NCIS预测早产儿败血症相关性脑病的比较

目的 比较振幅整合脑电图(aEEG)及新生儿危重病例评分(NCIS)预测早产儿败血症相关性脑病(SAE)的诊断价值。方法 选择2020年9月至2022年10月南京医科大学附属妇产医院新生儿重症监护病房(NICU)收治且病情最严重期间进行了aEEG监测的败血症早产儿为研究对象,根据SAE诊断标准,将47例败血症早产儿分为SAE组24例和非SAE组23例。两组败血症早产儿aEEG检查同时进行NCIS,比较两组患儿的一般资料、母孕期并发症、最差血气分析及aEEG监测时一般情况、疾病危重状况的差异,以及aEEG各参数的连续性、周期性、下边界振幅、带宽及总分和校正总分的差异。绘制SAE受试者工作特征(ROC)曲线,计算灵敏度、特异度和曲线下面积(AUC)。根据约登指数,比较NCIS和aEEG预测SAE的诊断价值。结果 两组败血症早产儿的一般资料、母孕期并发症、最差血气分析,及aEEG检查时的一般情况间的差异均无统计学意义(^(均)P>0.05),而NCIS、aEEG的连续性、周期性、下边界振幅、带宽、总分,均有统计学差异(^(均)P<0.05)。NCIS、aEEG的连续性、周期性、下边界振幅、带宽、aEEG总分,诊断SAE的AUC分别:0.727、0.726、0.884、0.706、0.849、0.890,约登指数分别0.406、0.703、0.703、0.412、0.746、0.701。结论 NCIS、aEEG连续性、周期性、带宽、总分,对诊断SAE有早期预测价值,aEEG比NCIS预测SAE效能更佳。

倍他米松磷酸钠注射液治疗早产有效性和安全性研究进展

倍他米松是地塞米松的同分异构体,具有抗炎、抗过敏、抗内毒素和免疫抑制等功能。倍他米松磷酸钠(BSP)注射液是倍他米松的磷酸盐制剂,作为一种糖皮质激素(ACS)类药物,其临床应用较广。BSP治疗早产已有充分的证据并被纳入各国指南,然而这些证据主要集中在高收入国家,中低收入国家相关证据则较少。我国关于BSP在产科应用疗效和安全性临床研究方面存在不足。关于倍他米松和地塞米松疗效和安全性直接比较的临床研究较少,BSP治疗早产后儿童期和成年期随访研究尚不足。因此,需进一步开展相关研究,为早产临床科学合理用药提供决策依据。

非O1/O139群霍乱弧菌致肝硬化失代偿期患者血流感染1例

患者,男性,58岁,乙型肝炎后肝硬化失代偿期、2型糖尿病12年,近1个月再发腹胀、水肿,尿少入院。住院期间患者寒战、发热,取血标本进行培养,选用头孢哌酮/舒巴坦经验性抗感染治疗。确诊非O1/O139霍乱弧菌引起的血流感染,药敏试验提示头孢哌酮/舒巴坦敏感后,继续使用当前药物,头孢哌酮/舒巴坦由3 g q12h改为3 g q8h治疗。10 d后患者无发热,血培养和粪便霍乱弧菌培养阴性,好转出院。

利奈唑胺联合免疫球蛋白治疗新生儿败血症的效果观察

目的分析利奈唑胺联合免疫球蛋白治疗新生儿败血症的效果。方法选取北京市房山区良乡医院2020年8月~2023年8月新生儿败血症92例为研究对象,随机分为两组。对照组(46例)采用利奈唑胺进行治疗,研究组(46例)采用利奈唑胺联合免疫球蛋白治疗。比较两组患儿临床疗效、炎症因子水平、免疫功能、症状体征改善情况。结果治疗后,研究组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平低于对照组(P<0.05);治疗前,两组免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)差异无统计学意义(P>0.05),治疗后两组IgM差异无统计学意义(P>0.05),研究组IgA、IgG高于对照组(P<0.05);研究组总有效率高于对照组(P<0.05);研究组各症状改善时间短于对照组(P<0.05)。结论利奈唑胺联合免疫球蛋白治疗新生儿败血症效果较好,可加速病情恢复,提高免疫功能,改善炎症因子水平。

婴儿芽孢杆菌致新生儿败血症1例报告

本文报告一例婴儿芽孢杆菌所致新生儿败血症病例。患儿系34周^(+3)天早产儿,表现为发热,反应差,皮肤大理石花纹,呼吸急促,口吐泡沫,C反应蛋白、降钙素原增高明显,而血常规变化不大。外周血病原学微生物宏基因检出婴儿芽孢杆菌。予以青霉素和头孢噻肟舒巴坦联合抗感染、支持等治疗后病情好转出院,随访至10个月生长发育正常。婴儿芽孢杆菌属于芽孢杆菌属,可引起新生儿早发型败血症,国内暂无婴儿芽孢杆菌败血症的报道。新生儿感染婴儿芽孢杆菌起病急、病情较重,应早期行病原体检测,并给予积极有效的抗感染治疗。

血清降钙素原和C反应蛋白检测在不同发病日龄新生儿败血症中的诊断价值

目的探究血清降钙素原(PCT)、C反应蛋白(CRP)在不同发病日龄新生儿败血症中诊断价值。方法选取2020年1月至2022年8月抚州市第一人民医院收治的60例败血症新生儿作为研究对象,以不同发病时间分为早发型组与晚发型组,各30例。所有患儿均行血清PCT、CRP检测,比较两组PCT、CRP水平,分析PCT、CRP检测及联合检测对新生儿败血症的诊断效能。结果晚发型组CRP、PCT水平均高于早发型组,差异有统计学意义(P<0.05)。PCT、CRP检测诊断新生儿败血症的截断值分别为6.21 mg/L、4.76μg/L,CRP联合PCT诊断新生儿败血症的AUC、灵敏度、特异度最高,分别为0.942、90.00%、93.33%,诊断效能最高。结论PCT、CRP诊断新生儿败血症的截断值分别为6.21mg/L、4.76μg/L,两者联合检测可提升对不同发病日龄新生儿败血症的诊断效能。

病毒性出血性败血症病毒数字PCR检测方法的建立

为建立病毒性出血性败血症病毒精准快速检测方法,以病毒性出血性败血症病毒基因组特异保守的糖蛋白基因片段为靶目标,设计合成了特异性引物及探针,优化退火温度等关键反应条件,分别进行灵敏性试验、特异性试验及重现性试验,构建病毒性出血性败血症病毒数字PCR检测技术体系,同时,与实时荧光定量RT-PCR方法进行对比分析。试验结果显示,病毒性出血性败血症病毒数字PCR最佳退火温度为58.5℃。灵敏性试验显示,随着病毒性出血性败血症病毒基因组RNA连续10倍稀释,稀释至105倍数时,数字PCR体系仍可以检测到阳性微滴,因此,确定RNA基因组核酸含量19拷贝/μL为病毒性出血性败血症病毒数字PCR的检测低限。特异性试验表明,该方法只与目标病毒——病毒性出血性败血症病毒有特异性扩增,与传染性胰脏坏死病毒、传染性造血器官坏死病毒、鲤春病毒血症病毒、流行性造血器官坏死病毒、牙鲆弹状病毒、病毒性神经坏死病毒、锦鲤疱疹病毒、鲤浮肿病毒、真鲷虹彩病毒、淋巴囊肿病毒等10种病毒均无扩增反应。重复性试验结果表明,病毒性出血性败血症病毒数字PCR批内与批间试验的变异系数均小于1%,具备良好的重复性。利用构建的数字PCR方法,对收集到的国内及进境鱼类样品共计1210批次进行病毒性出血性败血症病毒检测,结果显示,数字PCR阳性样本检出率为9.5%,常规实时荧光定量RT-PCR阳性样本检出率为7.69%~7.77%。临床试验结果表明,研究建立的病毒性出血性败血症病毒数字PCR方法较常规技术具有更高的检测灵敏性,适用于水生动物疫病精准检测的需求。

未足月胎膜早破新生儿早发型败血症的影响因素logistic模型分析

目的:通过logistic模型分析未足月胎膜早破(preterm premature rupture of membranes,PPROM)新生儿早发型败血症的影响因素。方法:回顾性分析2020年3月—2023年3月厦门大学附属成功医院出生的130例PPROM新生儿的临床资料。以出生后72 h内是否发生早发型败血症(early-onset sepsis,EOS)为依据,分为EOS组(n=18)、非EOS组(n=112),统计两组的相关资料并进行单因素、多因素分析,探究PPROM新生儿EOS的影响因素。结果:两组孕产妇肥胖、发生胎膜早破时胎龄、Ⅲ~Ⅳ级呼吸窘迫综合征(respiratory distress syndrome,RDS)、出生时低体重、新生儿窒息比较,差异有统计学意义(P<0.05);两组高龄、初产妇、妊娠期糖尿病、妊娠期高血压疾病、宫颈机能不全、胎盘早剥、组织学绒毛膜羊膜炎、产前抗生素治疗比较,差异无统计学意义(P>0.05);两组新生儿性别、娩出方式、预防性应用抗生素比较,差异无统计学意义(P>0.05);多因素logistic回归结果显示,出生时体重(OR=4.402、P=0.018)、Ⅲ~Ⅳ级RDS(OR=2.678、P=0.020)为影响PPROM新生儿发生EOS的危险因素。结论:PPROM新生儿EOS的影响因素与出生时低体重、Ⅲ~Ⅳ级RDS有密切联系,因此,对存在此类高危因素的新生儿,需及时采取有效的针对性干预措施,从而降低发病率及死亡率。

超/极低出生体重儿嗜酸性粒细胞增多症与支气管肺发育不良的临床相关性分析

目的探讨发生不同程度嗜酸性粒细胞增多症的超低出生体重儿(extremely low birth weight infants,ELBW)和极低出生体重儿(very low birth weight infants,VLBW)的临床特点,以及嗜酸性粒细胞增多症与支气管肺发育不良(bronchopulmonary dysplasia,BPD)的相关性。方法回顾性分析2019年1月至2022年12月解放军总医院第五医学中心儿科收治的147例ELBW及VLBW患儿的临床资料。根据嗜酸性粒细胞计数升高程度进行分组:正常组(嗜酸性粒细胞计数<0.7×10^(9)/L,n=43),轻度升高组[嗜酸性粒细胞计数为(0.7~0.9)×10^(9)/L,n=39]、中重度升高组(嗜酸性粒细胞计数≥1.0×10^(9)/L,n=65),比较各组围产期资料以及出生后相关疾病的发生率。根据患儿是否患有BPD以及BPD的严重程度分为无BPD组(n=81),轻度BPD组(n=46),中重度BPD组(n=20),比较3组患儿之间嗜酸性粒细胞计数的差异。统计学方法包括t检验、方差分析、秩和检验、χ^(2)检验、Fisher确切概率法,以及单因素和多因素Logistic回归分析、受试者工作特征(receiver operating characteristic,ROC)曲线。结果嗜酸性粒细胞增多症的发病率为70.7%(104/147),其中轻度升高26.5%(39/147),中重度升高44.2%(65/147)。中重度升高组和轻度升高组胎龄均小于正常组,差异均有统计学意义(P值均<0.05)。嗜酸性粒细胞计数轻度、中重度升高组中败血症、Ⅱ度以上呼吸窘迫综合征(respiratory distress syndrome,RDS)、BPD、血液输注的发生率明显高于正常组;中重度升高组患儿的BPD发生率高于轻度升高组;轻度、中重度升高组无创呼吸机应用时间均长于正常组,差异均有统计学意义(P值均<0.05)。无BPD组和BPD组患儿的胎龄、败血症的发生率以及嗜酸性粒细胞增多症、呼吸机应用天数、血液输注比较,差异均有统计学意义(P值均<0.05)。多因素Logistic回归分析结果显示,胎龄、嗜酸性粒细胞增多症、呼吸机应用天数、血液输注、败血症与BPD的发生具有独立相关性(P值均<0.05)。出生后第3周嗜酸性粒细胞计数的曲线下面积(area under the curve,AUC)最大(0.772),灵敏度及特异度均较高(70.1%、76.2%),提示对BPD的预测价值较好。出生后第3、4周轻度BPD组患儿嗜酸性粒细胞计数高于无BPD组(Z=-3.178、-2.475,P=0.001、0.013)。出生后第3、4周中重度BPD组患儿嗜酸性粒细胞计数高于无BPD组(Z=-2.601、-2.460,P=0.009、0.014)。出生后第3周中重度BPD组患儿嗜酸性粒细胞计数高于轻度BPD组(Z=-2.422,P=0.015)。结论ELBW及VLBW新生儿嗜酸性粒细胞增多症发生率较高,并且嗜酸性粒细胞增多症与BPD的发生存在一定的相关性。出生后第3周嗜酸性粒细胞计数预测BPD的灵敏度及特异度最高,临床上应加以重视。

Transcription profiles of skin and head kidney from goldfish suffering hemorrhagic septicemia with an emphasis on the TLR signaling pathway

DEAR EDITOR, Hemorrhagic septicemia is an acute, highly fatal disease that affects goldfish (Carassius auratus). To gain a better understanding of related immune genes, the transcriptomes of the skin and head kidney of goldfish suffering hemorrhagic septicemia were sequeneed, assembled, and characterized.

Effects of altitude hypoxia on contents of TXB_2, 6-keto-PGF_(1α) and LENK and their correlations with lung injury induced by pyosepticemia

Objective: To explore the effects of altitude hypoxia on septic pulmonary injury (3080 m above sea level). Methods : A model of pyosepticemia was established by cecal ligation and puncture. Thromboxane A2 (TXA2),prostacyclin (PGI2) of the venous plasma and leucine-enkephalins (L-ENK) in the arterial walls were measured using radioiizimunoassay in 31 rabbits. Mouse morrality was observed. Results: 24 h mouse accumulative mortality (97. 1% )was greater than that of control (35%). TXB2 content was 4 times as much as in control group and 6-keto-PGF1α level was elevated too. These changes of arachidonic metabolism could be blorked by indomethacin. The contents of LENK in arterial walls of puhiionary, mesenteric and renal arteries dropped significantly in comparison with control group (P<0. 01 ). The albumin content in the bronchoalveolar lavage fluid rase significantly in comparison with control group (P<0. 01 ). Conclusion : The results demonstrate that the metabolites of cyclcoxygenase are not the major mediator of puhiionary permeability in the experiment. The alteration of TXA2 and L-ENK contents may be one of the mechanisms, by which the puhiionary artery pressure and pulmonary vascular resistance are increased during sepsis.

Effect of Xingnaojing injection on intestinal mucosal barrier in septicemia and intracerebral hemorrhage mice

OBJECTIVE Xingnaojing injection(XNJ) is an extracts of Angong Niuhuang Pill that is a well-known traditional Chinese medicine used for the treatment of septicemia and stroke.This study aims to investigate the effect of XNJ on intestinal mucosal barrier in septicemia and intracerebral hem.orrhage(ICH) mice models.METHODS The septicemia mice models were induced by intravenous in.jection with lipopolysaccharide(20 mg·kg^(-1)).And the ICH mice models were made by intrastriatal injec.tion of bacterial collagenase.The septicemia animals were treated intravenously with XNJ at dose of2.5,5,10,or 15 mL·kg^(-1).The ICH animals were treated intravenously with XNJ at dose of 10 mL·kg^(-1).Thereafter,the permeability of intestinal mucosa was assayed by FITC-D method.RESULTS Com.pared with the control group(44.72±4.30),the permeability of intestinal mucosa in the mice in septice.mia group(233.68±28.18) was significantly increased(P<0.01).Treatment with XNJ at dose of 5,10,and 15 mL·kg^(-1) reduced the permeability of intestinal mucosa(150.45±17.52,139.21±17.05,132.55±18.88,respectively,P<0.01) except 2.5 mL·kg^(-1)(240.71±21.42,P>0.01);Compared with sham group(57.88±7.31),the permeability of intestinal mucosa in the mice of ICH(282.25±23.78) was significantly in.creased(P<0.01).Treatment with XNJ(10 mL·kg^(-1)) in the mice of ICH group ameliorated the change of permeability in intestinal mucosa(148.83±15.86,P<0.01).CONCLUSION XNJ exhibits the protec.tive effect on the intestinal mucosal barrier in septicemia and ICH,which will prevent the endotoxin to penetrate the intestinal mucosa and then to enter the circulation in infections and stress.

Pseudomonas aeruginosa Community Acquired Pneumonia with Septicemia in a Previously Healthy Woman

A previously healthy 53-year-old woman was urgently hospitalized due to septic shock. She was diagnosed with bacterial pneumonia based on chest radiograph and computed tomography findings of right upper lobe consolidation. Sputum Gramstain at the time of admission showed gram-negative rods with phagocytosis. Intravenous meropenem was immediately initiated as empiric antibacterial therapy. Bacterial culture specimens from sputum and blood were positive for Pseudomonas aeruginosa. Following appropriate antibiotic therapies, the patient recovered from a shock state and gradually became well. There has been no evidence of recurrence at 6 months after discharge. P. aeruginosa community acquired pneumonia with septicemia is rapidly progressive and often fatal. The choice of initial empiric antibiotic treatment that is active against P. aeruginosa is critical in improving outcome.

Establishment of Pyrosequencing Technology for Detecting Viral Hemorrhagic Septicemia Virus (VHSV)

[Objective] The paper was to establish pyrosequencing methods for detecting viral hemorrhagic septicemia virus （VHSV）. [ Method ] One pair of PCR primers and one pyrosequencing primer of VHSV were designed. The pyrosequencing reaction system and conditions were optimized and the pyrosequencing method for detecting VHSV was established. [ Result] This method was only able to specifically detect the objective viruses in the eight fish viruses, and the method had the advantage of high sensitivity. The minimum detectable limit of nucleic acid was 82 copies/μL. The method was verified by detecting VHSV in 1 924 batches of samples collected from domestic and imported fishes. The detection results were consistent with that of traditional RT-PCR, and the specificity and sensitivity of the method could meet the detection requirement for aquatic animal diseases. [ Conclusion] The study provides a new detection method for monitoring and prevention and control of aquatic animal virus diseases.

<i>Vibrio vulnificus</i>septicemia and necrotizing fasciitis in the patients with liver cirrhosis and diabetes mellitus

Vibrio vulnificus (V. vulnificus) infection is a rare disease in Japan but the leading cause of death related to raw seafood consumption. We hereby reported a successfully treated case of V. vulnificus septicemia, severe necrotizing fasciitis, disseminated intravascular coagulation and multiple organ failure after raw perch consumption with underlying alcoholic liver cirrhosis and diabetes mellitus. It is the first report of a case of V. vulnificusinfection caused by eating raw perch, whereas V. vulnificus infection should be suspected in all of middle-aged to elderly men with underlying immunosuppressive diseases, who have recent consumption of raw seafood or contact with seawater, especially in the summer. The levels of HbA1c and glycoalbumin were not high in the present case, however, obvious hyperglycemia was found even after the infection had completely healed. On reviewing 166 case of V. vulnificus infection in Japan including ours, the complication of diabetes mellitus, one of immunocompromised condition, was found only in 11%, although it had been reported that individuals strongly suspected of having diabetes were 17.2% among the Japanese male population aged from 40 to 74 years. Because diabetes mellitus might be underdiagnosed in the previous reports, intensive examinations are considered to be necessary in order to correctly diagnose diabetes mellitus in patients with severe V. vulnificus infection.

Development of an Indirect Sandwich ELISA for Detection of Duck Swollen Head Septicemia Virus

[Objective] To develop an indirect sandwich ELISA for rapid detection of duck swollen head septicemia virus （DSHSV）. [Method] DSHSV hyperimmune sara were prepared in ducks and rabbits by inoculation with DSHSV XD strain and then purified using saturated ammonium sulfate and Sephadex G-150 column chromatography to obtain anti-DSHSV IgG. An indirect sandwich ELISA was developed using the purified duck anti-DSHSV IgG and rabbit anti-DSHSV IgG after reaction conditions were optimized. Its specificity, sensitivity and repeatability were evaluated, and its accuracy was confirmed by observation with immunoelectron microscopy. Then, distribution of DSHSV in tissues of challenged ducks was also detected. [Result] Through optimizing conditions, the ELISA was developed. Only DSHSV could be detected by the developed method, but other pathogens could not be detected. Compared with agar gel diffusion test, the developed method was more sensitive. The coefficient of variation was less than 10%, and the developed method had good repeatability. In addition, the ELISA-positive samples contained DSHSV, as confirmed by im- munoelectron microscopy. All heart, liver, lung and kidney collected from the DSHSV-challenged ducks were positive when they were detected by the developed ELISA. [ Conclusion] The developed ELISA method is rapid, simple, specific and sensitive, and it is suitable for large-scale quaran- tine of DSHS. Heart, liver, lunq and kidney should be selected preferentially as specimens for diaclnosis of DSHS.

美洲鳗鲡“脱黏败血综合征”病原的分离鉴定及其致病性研究

为明确美洲鳗鲡“脱黏败血综合征”的病原,本研究采集福建省某养殖场的美洲鳗鲡病料组织样品制备病理切片,观察各组织病变,结果显示,病鳗的鳃、肝脏和肾脏呈现广泛性红细胞渗出和组织细胞变性、坏死。将病料样品接种鳗鲡肾脏细胞系(EK)进行病毒的分离,对分离病毒经电镜观察,结果显示,接种病料样品匀浆液的EK细胞出现合胞体病变,可见细胞核内有大量直径约120 nm的病毒。提取病毒基因后作为模板,采用PCR鉴定,结果证实其为鳗鲡疱疹病毒(AngHV),将其命名为AngHV-20713。进一步扩增分离病毒的ORF71基因并分析其同源性和遗传进化关系,结果显示,AngHV-20713与其它AngHV的同源性为93.6%~99.0%,且与分离自美洲鳗鲡的AngHV亲缘关系最近。将分离病毒以106 pfu/尾腹腔注射健康的美洲鳗鲡和欧洲鳗鲡,进行人工感染实验,结果显示,AngHV-20713对鳗鲡具有致病性,感染鳗鲡可见体表黏液脱落、胸鳍出血等“脱黏败血综合征”症状,并导致美洲鳗鲡60%的发病率和20%的死亡率,而感染的欧洲鳗鲡死亡率高达56.7%。利用qPCR从感染病毒的美洲鳗鲡各组织内均可检测到AngHV,从内脏可再次分离培养到AngHV-20713,表明AngHV是美洲鳗鲡“脱黏败血综合征”的病原。本研究为深入开展鳗鲡“脱黏败血综合征”的防控研究奠定了基础。

Value of PCT content for adjuvant diagnosis of neonatal septicemia and assessment of its severity

Objective:To evaluate the value of procalcitonin (PCT) content for adjuvant diagnosis of neonatal septicemia and assessment of its severity.Methods: A total of 100 newborns who were diagnosed with septicemia in the First People's Hospital of Xianyang City between January 2017 and January 2018 were selected as the septicemia group of the research, and the newborns who were born in the First People's Hospital of Xianyang City during the same period, with the general data matched with those of septicemia group and without neonatal diseases after born were selected as the control group. Serum was collected to determine the contents of PCT, inflammatory cytokines and immune cytokines, and peripheral blood was collected to determine the expression intensity of inflammatory signaling molecules and immune transcription factors.Results: Serum PCT, TNF-α, HMGB1, ICAM-1, IL-10 and IL-17 contents as well as peripheral blood TLR4, NF-κB, MPO, RORγt and FOXP3 expression intensity of septicemia group were significantly higher than those of control group whereas peripheral blood HLA-DR expression intensity was lower than that of control group;peripheral blood TLR4, NF-κB, MPO, RORγt and FOXP3 expression intensity as well as serum TNF-α, HMGB1, ICAM-1, IL-10 and IL-17 contents of septicemia group of newborns with high PCT were significantly higher than those of newborns with low PCT whereas peripheral blood HLA-DR expression intensity was lower than that of newborns with low PCT.Conclusion: The increase of PCT in serum of newborns with septicemia is related to the change of inflammatory response and immune response, and its content detection is valuable for assessing the severity of the disease.

Value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia

Objective: To explore the value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia. Methods: 48 children who were diagnosed with neonatal septicemia in our hospital between March 2015 and May 2018 were selected as the septicemia group, and 50 healthy neonates delivered in our hospital during the same period were selected as the normal control group. The differences in PCT and inflammatory factor contents in serum as well as liver and kidney function index levels in peripheral blood were compared between the two groups. Pearson test was used to evaluate the correlation of serum PCT content with inflammatory factor release as well as liver and kidney function injury in children with neonatal septicemia. Results: The serum PCT content of septicemia group was significantly higher than that of normal control group;serum hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8 (IL-8) and soluble intercellular adhesion molecule-1 (sICAM-1) contents were higher than those of normal control group;peripheral blood aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γ-GGT) and alkaline phosphatase (ALP) levels were higher than those of normal control group;peripheral blood blood urea nitrogen (BUN), serum creatinine (Scr) and serum β2-microglobulin (β2-M) levels were higher than those of normal control group (P<0.05). Correlation analysis showed that serum PCT content in children with neonatal septicemia was directly correlated with the degree of inflammatory response as well as the degree of liver and kidney function injury (P<0.05). Conclusion: The serum PCT content abnormally increases in children with neonatal septicemia, and the specific content is consistent with the disease severity and has certain clinical value for the judgment of children's condition.

IL-6、IL-17、Th17与Treg在诊断新生儿败血症中的价值

目的 探讨外周血白细胞介素-6(IL-6)、IL-17、辅助性T细胞17(Th17)与调节性T细胞(Treg)在新生儿败血症治疗前后表达水平的变化。方法 收集2020年8月至2022年1月期间常德市第一人民医院的新生儿败血症患者86例作为观察组,129例新生儿非败血症患者作为对照组。检测患儿外周血中IL-6、IL-17、Th17、Treg、Th17/Treg的表达水平,比较上述指标在观察组治疗前后和对照组之间的差异,分析其在治疗前的相关性。结果 (1)观察组治疗前后和对照组的IL-6、Treg、Th17/Treg检测值的差异均具有统计学意义(H值分别为28.900、9.610、6.780,P<0.05)。(2)观察组早产儿治疗后的IL-6、IL-17、Th17/Treg水平均低于治疗前(Z值分别为-2.850、-2.150、-3.400,P<0.05);观察组早产儿治疗后的Treg水平高于治疗前(t=-2.440,P<0.05)。(3)观察组足月产儿治疗后的IL-6、Th17/Treg水平均低于治疗前(Z值分别为-4.570、-3.020,P<0.05),观察组足月产儿治疗后的Treg水平高于治疗前(Z=-2.640,P<0.05)。(4)观察组患儿治疗前外周血IL-6、IL-17与Th17表达水平呈正相关(r值分别为0.507、0.730,P<0.05);IL-6与Treg表达水平呈负相关(r=-0.336,P<0.05);IL-17与Treg表达水平无相关性(P>0.05)。结论 Th17与Treg细胞免疫平衡稳态的打破与新生儿败血症的发生发展密切相关。IL-6介导新生儿败血症Th17与Treg细胞免疫平衡稳态的打破。