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血浆IL-8是新生儿早期细菌感染(EOBI)的早期诊断指标,但是其半衰期较短。而净化剂溶解的全血(DLWB)IL-8既包括细胞外IL-8,也包括细胞结合型IL-8。此目的是研究健康新生儿和怀疑EOBI新生儿的血浆和DLWB中IL-8的代谢动力学,进而检证DLWB 中IL-8浓度测定对诊断EOBI具有更高的敏感性这一假想。研究组包括了61例具有EOBI临床或血清学征象的新生儿;188例具有感染风险因素但没有EOBI的新生儿编入对照组。测定血浆和DLWB中IL-8的浓度。在对照组中,新生儿直到出生后24 h内DLWB中IL-8浓度比相应的血浆IL-8浓度(34.2 ng/L,s= 18.1)升高了280倍(9 599 ng/L,s=4 433)。DLWB中IL-8浓度对EOBI的敏感度与血浆相比,出生6 h后是0.97 vs 0.71,出生24 h后是0.70 vs 0.32。两者的特异性相应值相比,出生6 h后是0.95 vs 0.90,出生24 h 后是0.92 vs 0.99。出生24 h后,DLWB中IL-8EOBI 阴性预测值与血浆IL-8相比是0.80 vs 0.66。结果显示DLWB中IL-8在临床怀疑EOBI最初6 h内比血浆中IL-8具有较高的敏感性。而且其增高能保持较长时间。笔者认为检测DLWB中IL-8的水平对EOBI的诊断具有较高的敏感性。
Plasma IL-8 is an early diagnostic indicator of early neonatal bacterial infection (EOBI) but has a short half-life. While scavenger-solubilized whole blood (DLWB) IL-8 includes both extracellular IL-8 and cell-associated IL-8. The aim of this study was to investigate the pharmacokinetics of IL-8 in plasma and DLWB of healthy newborns and suspected EOBI infants and to examine the hypothesis that IL-8 concentrations in DLWB are more sensitive to the diagnosis of EOBI. The study group included 61 neonates with clinical or serological EOBI signs; 188 newborns with infection risk factors but no EOBI were included in the control group. IL-8 concentrations in plasma and DLWB were measured. In the control group, the neonatal IL-8 concentration in DLWB was 280-fold (9 599 ng / L, s) higher than the corresponding plasma IL-8 concentration (34.2 ng / L, s = 18.1) = 4 433). The sensitivity of IL-8 concentration in DLWB to EOBI was 0.97 vs 0.71 at 6 h after birth and 0.70 vs 0.32 at 24 h after birth. The specificity of the two was 0.95 vs 0.90 at 6 h after birth and 0.92 vs 0.99 at 24 h after birth. After 24 h of birth, the negative predictive value of IL-8EOBI in DLWB was 0.80 vs 0.66 compared with plasma IL-8. The results showed that IL-8 in DLWB was more sensitive than IL-8 in plasma during the first 6 h of clinical suspicion of EOBI. And its increase can maintain a long time. I believe that the detection of IL-8 levels in DLWB has a high sensitivity to the diagnosis of EOBI.