摘要
目的探讨C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)和降钙素原(PCT)水平在新生儿败血症早期诊断中的意义。方法 69例新生儿分为败血症患儿(A组,35例)和健康新生儿(B组,34例),采用ELISA法检测血清IL-6和TNF-α水平,免疫发光法和免疫比浊法分别检测PCT和CRP水平。绘制受试者工作特征曲线,确定CRP、IL-6、TNF-α和PCT的最佳截断值,计算灵敏度、特异度、阳性预测值、阴性预测值、约登指数及曲线下面积。结果 A组CRP、IL-6、TNF-α和PCT水平均高于B组(P<0.01)。CRP、IL-6、TNF-α和PCT最佳截断值分别为12mg/L、3.6pg/ml、7.5pg/ml和0.38ng/ml;TNF-α和PCT最佳截断值在诊断新生儿败血症灵敏度和特异度均高于CRP和IL-6(P<0.05)。结论 TNF-α和PCT在新生儿败血症的早期诊断中较CRP、IL-6更有价值。
Objective To investigate the significance of C‐reactive protein（CRP） ,interleukin‐6 （IL‐6） ,tumor necrosis factor‐α（TNF‐α） and procalcitonin （PCT ） in the early diagnosis of neonatal sepsis .Methods A total of 69 newborns was divided into two groups of A （with neonatal sepsis ,35 cases） and B（healthy newborns ,34 cases） .The contents of IL‐6 and TNF‐αwere detected by ELISA . The levels of PCT and CRP were measured by immunoluminometric and immunoturbidimetric assays , respectively .The best cut‐off values of CRP ,IL‐6 ,TNF‐α and PCT were determined by receiver‐operating characteristic （ROC ） curves ,and the sensitivity ,specificity ,positive predictive value , negative predictive value ,Youden′s index and the area under ROC curve were then calculated .Results The levels of CRP ,IL‐6 ,TNF‐αand PCT in group A were higher than those in group B（P〈0 .01） . The best cut‐off values of CRP ,IL‐6 ,TNF‐α and PCT were 12 mg/L ,3.6 pg/ml ,7.5 pg/ml and 0.38 ng/ml ,respectively .Taking TNF‐α 7.5 pg/ml and PCT 0.38 ng/ml as the cut‐off values ,the sensitivity and specificity for the diagnosis of neonatal sepsis were 100% ,100% and 96.6% ,96.4% . Conclusion Detecting the levels of TNF‐αand PCT is more effective in the early diagnosis of neonatal sepsis than that of IL‐6 and CRP .
出处
《江苏医药》
CAS
2015年第12期1415-1417,共3页
Jiangsu Medical Journal
