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    脐血IL-6在早产儿早发型败血症的诊断价值

    The value of umbilical cord blood IL-6 in the diagnosis of early-onset septicemia in premature infants

    • 摘要: 目的 检测早产儿脐血中白细胞介素(IL-6)的水平,评价其在早产儿早发型败血症的诊断价值。方法 选取2017年1月—2018年1月北京市顺义区妇幼保健院收治的早发型败血症早产儿作为败血症组,共39例,同期入院的非败血症早产儿作为非败血症组,共53例。收集入组病例的相关临床资料。采用ELISA法测定脐血和外周血IL-6水平,采用ROC曲线计算脐血及外周血IL-6诊断早发型早产儿败血症的临界值、灵敏度和特异度,并计算ROC曲线下面积(AUC)。结果 与非败血症组相比,败血症组的出生体重更低,胎膜早破时间更早;少吃、少哭、少动、腹胀、皮肤发花的发生率更高,差异有统计学意义(P<0.05)。实验室指标,乳酸、总胆红素、C反应蛋白、脐血及外周血IL-6均更高,差异有统计学意义(P<0.05)。根据ROC曲线可知,脐血IL-6的AUC为0.757,95%CI(0.651~0.863),临界值为17.6 ng/L,灵敏度为56.4%,特异度为94.3%;外周血IL-6的AUC 为0.768,95% CI(0.665~0.871),临界值为2.05 ng/L,灵敏度为69.2%,特异度为83.0%。结论 脐血IL-6在败血症早期明显升高,在诊断早产儿早发型败血症中可能具有临床意义。

       

      Abstract: Objective To detect the level of interleukin-6 (IL-6) in umbilical cord blood and evaluate its use in the diagnosis of premature infants with early-onset septicemia. Methods A total of 39 premature infants who were diagnosed with early-onset septicemia in Maternal and Child Healthcare Hospital of Shunyi District, Beijing from January 2017 to January 2018 were selected as a septicemia group. Meanwhile, another 53 non- septicemia premature infants who were admitted during the same period were select as a non- septicemia group. Their clinical data were collected. The levels of IL-6 in umbilical cord blood and peripheral blood were measured by ELISA. The ROC curves of umbilical cord blood and peripheral blood IL-6 in the diagnosis of septicemia were spotted. Results Compared with the non- septicemia group, the septicemia group presented decreased birth weight and shortened time of premature rupture of membranes, with increased incidences of less eating, less crying, less movement, abdominal distention and skin blossom (P<0.05). The levels of lactate, total bilirubin, C-reactive protein, and IL-6 in umbilical cord blood and peripheral blood were significantly higher in the septicemia group than those in the non-septicemia group (P<0.05). The ROC curve showed that the AUC of IL-6 in umbilical cord blood was 0.757, 95% CI (0.651-0.863), where the threshold value was 17.6 ng/L, the sensitivity was 56.4%, and the specificity was 94.3%. The AUC of IL-6 in peripheral blood was 0.768, 95% CI (0.665-0.871), where the threshold was 2.05 ng/L, the sensitivity was 69.2%, and the specificity was 83.0%. Conclusions The level of IL-6 in umbilical cord blood significantly increases on the early stage of septicemia, which may have clinical significance in the diagnosis of premature infants with early-onset septicemia.

       

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