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目的:探讨C-反应蛋白(CRP)、降钙素原(PCT)及白介素-6(IL-6)在早期诊断胎膜早破新生儿败血症的应用价值。方法:收集2012年3月~2013年3月于该院治疗的胎膜早破新生儿58例,其中30例败血症患儿作为观察组,另28例正常新生儿作为对照组。于新生儿出生后第1天检测其静脉血CRP、PCT及IL-6水平,3天后再次检测CRP、PCT。结果:观察组患儿出生时IL-6为(100.32±38.72)ng/L明显高于对照组(4.56±2.19)ng/L(P<0.05);观察组患儿出生时的CRP为(8.74±3.32)mg/L明显高于对照组(2.35±1.09)mg/L(P<0.05)。观察组患儿出生时、3天后的PCT分别为(7.02±5.23)μg/L、(10.76±3.27)μg/L,明显高于对照组(1.19±8.24)μg/L、(1.21±1.42)μg/L(P<0.05)。CRP与PCT在新生儿出生时诊断感染的临界值分别为7.2 mg/L和1.69μg/L,其敏感性与特异性分别为56%和60%,77%和85%。第3天CRP和PCT的临界值为7.6 mg/L和1.82μg/L,敏感性和特异性分别为60%和67%,91%和87%。而对于IL-6新生儿出生时临界值为7.8 ng/L,其敏感性和特异性分别为93%和96%。结论:败血症患儿出生时的IL-6指标的敏感性及特异性最强,PCT指标的敏感性稍优于CRP。
Objective: To investigate the value of C-reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6) in the early diagnosis of neonatal sepsis with premature rupture of membranes. Methods: Fifty-eight neonates with premature rupture of membranes in our hospital were collected from March 2012 to March 2013. Thirty children with sepsis were selected as the observation group and the other 28 normal neonates as control group. The levels of CRP, PCT and IL-6 in venous blood were detected on the first day after birth and again after 3 days. Results: The IL-6 level in the observation group was significantly higher than that in the control group (100.32 ± 38.72 ng / L, 4.56 ± 2.19 ng / L, P <0.05; CRP was 8.74 ± 3.32) mg / L was significantly higher than that of the control group (2.35 ± 1.09) mg / L (P <0.05). The PCT at 3 days after birth in the observation group was (7.02 ± 5.23) μg / L and (10.76 ± 3.27) μg / L, which was significantly higher than that in the control group (1.19 ± 8.24) μg / L and (1.21 ± 1.42) μg / L (P <0.05). The cutoff values of CRP and PCT were 7.2 mg / L and 1.69 μg / L for neonatal birth, respectively. The sensitivity and specificity of CRP and PCT were 56% and 60%, 77% and 85% respectively. The cut-off values for CRP and PCT on day 3 were 7.6 mg / L and 1.82 μg / L with sensitivities and specificities of 60% and 67%, 91% and 87%, respectively. For neonates with IL-6, the cutoff value of 7.8 ng / L at birth was 93% and 96%, respectively. CONCLUSIONS: The sensitivity and specificity of IL-6 at birth in children with sepsis are strongest, and the sensitivity of PCT is slightly better than that of CRP.