败血症新生儿血清白细胞介素-8诊断价值探讨(1)

http://www.100md.com 2011年8月1日 吴志军 陈睿 陈幽 黄上明 王维 卢光进

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     [摘要] 目的 探讨败血症、细菌感染、病毒感染新生儿血清IL-8水平变化临床诊断价值。方法 30例健康新生儿脐血IL-8及新生儿病房46例疑诊为感染新生儿入院24小时内血清IL-8测定，同时进行血液细菌培养及血白细胞、CRP、外周血细胞涂片、痰培养、胸片等检测。结果 诊断败血症15例(其中血培养阳性败血症11例、临床败血症4例)、细菌性肺炎组23例、病毒感染组8例，各组血清IL-8分别为89ng/L、76.5 ng/L、52.7 ng/L，健康新生儿脐血IL-8为11.3 ng/L。早发败血症与晚发败血症、足月儿败血症与早产儿败血症血靖L-8水平差异无显著性。败血症组血清IL-8水显著高于病毒感染组及健康新生儿组(P<0.05)，ROC曲线提示当IL-8水平超过55.5 ng/L时败血症诊断灵敏度为80%、特异度75%，而同细菌性肺炎组比较差异无显著性。结论 败血症新生儿起病早晚及不同胎龄对血清IL-8水平无影响。血清IL-8水平超过55.5ng/L可作为新生儿败血症诊断阈值水平,具有重要的临床诊断应用价值。

    [关键词] 败血症 新生儿 血清白细胞介素-8 诊断价值

    [中图分类号] R515.3[文献标识码] A[文章编号] 1005-0515(2011)-08-006-02

    The Diagnos is Value of Plasma IL-8 in Newborns With Sepsis

    [Abstract] Objective To value the diagnosis power of plasma interleukin 8(IL-8) in newborns with sepsis or bacteria infection or virus infection.Methods Umbilical cord bloodIL-8 were measured in 30 healthy term-infants. Forty-six high risk infectious infants had blood samples for plasma IL-8 , CRP, white cell counts, blood smear ,blood sputum culture and Chest X-ray.Results Fifteen newborns with sepsis, twenty-three non-sepsis bacteria infection infants, eight virus infectious newborns who had been measured plasma IL-8 level 89ng/L,76.5 ng/L,52.7 ng/L respectively. Cord blood IL-8 level is 11.3 ng/L. Plasma IL-8 level were no significant difference between early-onset and late-onset or term and preterm infants.There were significant different in IL-8 level between sepsis and non-bacteria infection group, or sepsis and normal control group. When these infants with above 55.5ng/L IL-8 level.It is the sensitive and special of diagnosis to sepsis about 80% and 75% according to ROC. But there was no significant difference in IL-8 between non-sepsis bacteria infection and virus infection.Conclusion Different gestations and onset-time can't effect newborns' plasma IL-8 level with sepsis.55.5ng/L was determined as the suitable threshold for plasma IL-8 by ROC-curve analysis.

    [Keywords] Septicemia; Newborn; Serum interleukin-8; Diagnostic value

    新生儿败血症仍为NICU新生儿病死率较高的疾病之一，由于临床症体和体征不典型，病情进展快，暴发性病例极易错失最佳抢救时期，遗误病情。近年来实验室生化指标为临床医生早期合理、有效实施救治提供了非常重要的客观依据。白细胞介素-8(IL-8)是典型的炎症细胞趋化因子之一 ......

    http://www.100md.com/html/paper/1005-0515B/2011/08/05.htm

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