摘要
目的 评价急相蛋白、白细胞介素 6(IL 6)、白细胞介素 8(IL 8)及可溶性细胞间粘附分子 1(SICAM 1)对极低出生体重儿 (VLBWI)细菌感染早期诊断的价值 ,并探讨其内在联系。方法 对1998年 12月～ 2 0 0 0年 4月 ,新生儿病房收治的 42例VLBWI,按细菌感染的诊断标准分感染组 (败血症组与疑似败血症组 )共 2 3例和无感染组 19例。用散射比浊法与双抗体夹心ELLSA法 ,于入院后、第 3天、第 5天分别检测α1酸性糖蛋白 (α1AG)、C反应蛋白 (CRP)、结合珠蛋白 (HP)、铜蓝蛋白 (CP)及IL 6、IL 8、SICAM 1。结果 2 3例细菌感染患儿中 ,入院时IL 6的诊断敏感性最高 ,达 87% ,其次CRP与SCAM 1均为 74%、IL 8为 70 % ,α1AG、HP的敏感性最低 (4 3 % )、CP为 42 %。IL 6与CRP、HP、α1AG血清含量均密切相关 ,相关系数分别为 0 42 5、0 5 45、0 5 5 4(P分别 <0 0 5、<0 0 1、<0 0 1)。 结论IL 6对细菌感染的早期诊断有较高敏感性 ,而CRP敏感性低 ,但特异性高 (89% ) ,且两者有紧密内在联系 。
Objective Septicemia is a severe infection in very low birth weight infants (VLBWI), which usually results in death. Early diagnosis and treatment of septicemia in VLBWI could decrease infant mortality. Recently, many studies sought to explore the possibilities of early diagnosis of this disease. Acute-phase proteins, interleukin-6 (IL-6), interleukin-8 (IL-8), and soluble intercellular adhesion molecule-1 (SICAM-1) has been shown to be helpful to diagnose neonatal bacterial infection and septicemia. This study was designed to evaluate these biochemical factors for early diagnosis of bacterial infection in VLBWI. Methods Forty-two VLBWIs in our neonatology ward treated between December 1998 and April 2000 were divided into bacterial infection group (n=23) and non-infection group (n=19) according to the diagnostic criteria of bacterial infection. The infection group was further divided into bacteria-positive and negative groups. α 1-acid glucoprotein (α 1AG), C-reactive protein (CRP), haptoglobin (HP), ceruloplasmin (CP), IL-6, IL-8 and SICAM-1 were measured by nephelometry or using ELISA at the first, third, and fifth day after admission, respectively. Results All the factors in infective group at the first day after admission were significantly higher than control group (P<0.01), and their level deceased with time. IL-6, IL-8, SCAM-1 level in bacteria-positive group were significantly higher than those in bacteria-negative group (P<0.01). The sensitivity of diagnosis of bacterial infection at the first day after admission was 87% for IL-6, 74% for CRP and SICAM-1, 70% for IL-8, 43% for α 1AG and HP, and 42% for CP, respectively. IL-6 closely correlated with CRP (r=0.425, P<0.05), HP(r=0.545,P<0.01), and α 1AG (r=0.554, P<0.01). Conclusion It is suggested that IL-6 had a higher sensitivity for early diagnosis of bacterial infection in VLBWI, while CRP had higher specificity (89%) in spite of its lower sensitivity. IL-6 closely correlated with CRP. Both could be used as biochemical factors for early diagnosis of septicemia in VLBWIs.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2002年第11期686-689,共4页
Chinese Journal of Pediatrics
基金
温州市科委资助课题 (S990 30 6B)
