炎症指标及细胞因子检测在新生儿败血症早期诊断中的应用价值*

doi:10.3969/j.issn.1671-2587.2019.04.028

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (4): 435-437.DOI: 10.3969/j.issn.1671-2587.2019.04.028

炎症指标及细胞因子检测在新生儿败血症早期诊断中的应用价值^*

张克昌, 谢瑞玉, 李维春

239000 滁州市第一人民医院检验科

收稿日期:2018-12-21 出版日期:2019-08-20 发布日期:2019-08-28
通讯作者: 谢瑞玉,男,副主任检验师,主要从事临床生化方面研究,（E-mail）cz2ylab@163.com。
作者简介:张克昌（1973-）,男,主管检验师,硕士,主要从事分子免疫方面研究,（Tel）15178418976（E-mail）zhangkechangok123@163.com。
基金资助:
*本课题受2014安徽省滁州科技项目（No.201401）资助

Application Potential of Inflammatory Markers and Cytokines Detection in Early Diagnosis of Neonatal Sepsis

ZHANG Ke-chang, XIE Rui-yu, LI Wei-chun

Department of Clinical Laboratory, the First People's Hospital of Chuzhou, Chuzhou, Anhui 239000

Received:2018-12-21 Online:2019-08-20 Published:2019-08-28

摘要/Abstract

摘要： 目的探讨WBC、N%、CRP、PCT、IL-6、IL-27、IL-10、TNF-α指标在新生儿败血症早期诊断中的临床应用价值。方法采用流式细胞术检测外周血WBC、N%;采用免疫比浊法检测全血中CRP,免疫色谱分析法检测血浆中PCT;采用酶联免疫吸附试验（ELISA）测定患儿血浆中IL-27、IL-6、IL-10、TNF-α水平。结果新生儿败血症组第一天和第三天WBC、N%、CRP及PCT水平明显高于第七天及对照组（P<0.05）,第三天CRP浓度最高;联合检测炎症指标有利于提高其敏感性和特异性;败血症患儿第一天和第三天体内IL-6、IL-10、TNF-α水平明显高于第七天及健康对照组,败血症患儿体内IL-6、IL-27浓度第三天达到最高水平（P<0.05）。结论败血症患儿体内细胞因子IL-6、IL-27、IL-10、TNF-α水平在病情处于不同时间段的浓度不同;不同观察指标及不同指标联合检测的诊断灵敏度及特异性不同,联合及连续检测WBC、N%、PCT水平有利于提高对新生儿败血症的早期诊断价值。

关键词: WBC, CRP, PCT, 细胞因子, 新生儿败血症, 早期诊断

Abstract: Objective To explore the diagnostic value of WBC, N%, CRP, PCT, together with IL-6, IL-27, IL-10, and TNF-α for early diagnosis of neonatal sepsis. Methods Flow cytometry was used to detect WBC and N%. The CRP and PCT were detected with both immune turbidity and the immunochromatography in the sera of patients. The levels of IL-6, IL-27, IL-10 and TNF-α were measured with enzyme linked immunosorbent assay. Results The levels of WBC, N%, CRP and PCT on days 1 and 3 were higher than those on day 7 (P<0.05). Concentration of CRP on day 3 and PCT on day 1 was elevated compared to the other groups. The levels of IL-6, IL-10 and TNF-α on days 1 and 3 were obviously higher than those on day 7 (P<0.05) whereas IL-6 and IL-27 were found to be increased on day 3 in the neonatal patients with sepsis (P>0.05). Conclusion The levels of cytokines IL-6, IL-27, IL-10 and TNF-αvaried with the courses of neonatal sepsis. Combined detection of WBC, N%, PCT as well as the cytokines may be helpful for the early diagnosis of neonatal sepsis.

Key words: WBC, CRP, PCT, Cytokine, Neonatal sepsis, Early diagnosis

中图分类号:

张克昌, 谢瑞玉, 李维春. 炎症指标及细胞因子检测在新生儿败血症早期诊断中的应用价值^*[J]. 临床输血与检验, 2019, 21(4): 435-437.

ZHANG Ke-chang, XIE Rui-yu, LI Wei-chun. Application Potential of Inflammatory Markers and Cytokines Detection in Early Diagnosis of Neonatal Sepsis[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2019, 21(4): 435-437.

参考文献

1 余加林,吴仕孝.新生儿败血症诊疗方案[J].中华儿科杂志, 2003,41(12):897-899.
2 Yang A P,Liu J,Yue L H,et al. Neutrophil CD64 combined with PCT,CRP and WBC improves the sensitivity for the early diagnosis of neonatal sepsis[J].Clin chem lab Med,2016,54(2):345-351.
3 沈维维,吴瑛婷,孙文琴,等.IL-8,PCT及CRP联合检测在新生儿败血症诊断中的临床意义[J].现代生物医学进展,2017,17(11):2152-2154.
4 朱丽坤,温洁新.hs-CRP与PCT在新生儿败血症早期诊断及病情评估中的应用[J].实用医学杂志,2016,32(6):1002-1003.
5 黄丽娇,庄晖,刘丽明.联合检测PCT、IL-6和CRP水平在预测未足月胎膜早破患者并发绒毛膜羊膜炎及新生儿败血症的临床价值研究[J].中国妇幼保健,2016,31(17):3471-3474.
6 吴菠,张瑞,徐虹,等.198例新生儿败血症病原学及耐药性分析[J].中华医院感染学杂志,2017,27(14):3299-3302.
7 李亚林,陈永红,江胜,等.新生儿败血症76例血培养阳性结果及耐药性分析[J].蚌埠医学院学报,2017,42(1):64-66.
8 Zhang F,Fan X,Bai Y,et al.miR-125b regulates procalcitonin production in monocytes by targeting Stat3[J].Microbes Infect,2016,18(2):102-108.
9 Hosokawa Y,Shimizu T,Owari T,et al.Clinical Evaluation of Urosepsis in Tane General Hospital ; Clinical Utility of Measurement of Procalcitonin[J]. Hinyokika Kiyo,2017,63(7):259-262.
10 李志玲,徐峰,刘红霞,等.早期诊断标志物白细胞介素6、C反应蛋白在生儿感染的价值比较研究[J].中国儿童保健杂志,2015,23(11):1204-1207.
12 Pons M J,Gomes C,Aguilar R,et al.Immunosuppressive and angiogenic cytokine profile associated with Bartonella bacilliformis infection in post-outbreak and endemic areas of Carrion's disease in Peru[J].PLoS Negl Trop Dis,2017,11(6):e0005684.
12 Mchedlidze T,Kindermann M,Neves A T,et al.IL-27 suppresses type 2 immune responses in vivo via direct effects on group 2 innate lymphoid cells[J]. Mucosal Immunol,2016,9(16):1384-1394.
13 Roberts C A,Durham L E,Fleskins V,et al.TNF Blockade Maintains an IL-10(+) Phenotype in Human Effector CD4(+) and CD8(+) T Cells[J]. Front Immunol,2017,8:157.
14 Savarin C,Bergmann C C,Hinton D R,et al.Differential Regulation of Self-reactive CD4(+) T Cells in Cervical Lymph Nodes and Central Nervous System during Viral Encephalomyelitis[J].Front Immunol,2016,7:370.
15 Kim M J,Yoo Y C,Kim H J,et al. Aged black garlic exerts anti-inflammatory effects by decreasing no and proinflammatory cytokine production with less cytoxicity in LPS-stimulated raw 264.7 macrophages and LPS-induced septicemia mice[J]. J Med Food,2014,17(10):1057-1063.
16 Pape H C,van Griensven M,Rice J,et al. Major Secondary surgery in blunt trauma patients and perioperative cytokine liberation:determination of the clinical relevance of biochemical markers[J].J Trauma,2001,50(6):989-1000.

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炎症指标及细胞因子检测在新生儿败血症早期诊断中的应用价值^*

Application Potential of Inflammatory Markers and Cytokines Detection in Early Diagnosis of Neonatal Sepsis

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