| 施 佳,林雅婷,张潇月,楚晓云,蔡 成.血清sTREM-1、sTNFR-Ⅱ联合CF-6对新生儿早发型败血症的诊断和预后评估价值研究[J].,2024,(1):54-59 |
| 血清sTREM-1、sTNFR-Ⅱ联合CF-6对新生儿早发型败血症的诊断和预后评估价值研究 |
| Study on the Diagnostic and Prognostic Evaluation Value of Serum sTREM-1, sTNFR-II Combined with CF-6 in Neonatal Early-Onset Sepsis |
| 投稿时间：2023-09-20 修订日期：2023-10-12 |
| DOI：10.13241/j.cnki.pmb.2024.01.009 |
| 中文关键词: 新生儿 早发型败血症 sTREM-1 sTNFR-Ⅱ CF-6 诊断 预后 |
| 英文关键词: Neonate Early onset sepsis sTREM-1 sTNFR-Ⅱ CF-6 Diagnosis Prognosis |
| 基金项目:上海市2020年度"科技创新行动计划"医学创新研究专项项目（20Y11907000） |
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| 中文摘要: |
| 摘要 目的：探讨血清可溶性髓系细胞触发受体-1（sTREM-1）、可溶性肿瘤坏死因子受体-Ⅱ（sTNFR-Ⅱ）联合偶联因子-6（CF-6）对新生儿早发型败血症（EOS）的诊断和预后评估价值。方法：选取2021年1月～2023年1月上海市儿童医院收治的170例EOS患儿纳入EOS组，根据预后结局分为预后不良组和预后良好组，另选取我院同期100名无感染症状的健康新生儿纳入对照组。采用酶联免疫吸附法检测血清sTREM-1、sTNFR-Ⅱ、CF-6水平。通过多因素Logistic回归模型分析新生儿EOS预后不良的影响因素，受试者工作特征（ROC）曲线分析血清sTREM-1、sTNFR-Ⅱ、CF-6水平对新生儿EOS的诊断价值和预后不良评估价值。结果：与对照组比较，EOS组血清sTREM-1、sTNFR-Ⅱ、CF-6水平升高（P＜0.05）。170例EOS患儿预后不良发生率为29.41%（50/170）。多因素Logistic回归模型分析显示，出生体重≥2.5 kg、血小板计数增加为新生儿EOS预后不良的独立保护因素，胎膜早破和sTREM-1、sTNFR-Ⅱ、CF-6升高为独立危险因素（P＜0.05）。ROC曲线分析显示，血清sTREM-1、sTNFR-Ⅱ联合CF-6诊断新生儿EOS的曲线下面积（AUC）为0.943，大于sTREM-1、sTNFR-Ⅱ、CF-6单独诊断的0.802、0.821、0.816；血清sTREM-1、sTNFR-Ⅱ联合CF-6评估新生儿EOS预后的AUC为0.928，大于sTREM-1、sTNFR-Ⅱ、CF-6单独评估的0.774、0.785、0.779。结论：EOS患儿血清sTREM-1、sTNFR-Ⅱ、CF-6水平升高，且与预后不良密切相关，血清sTREM-1、sTNFR-Ⅱ联合CF-6对新生儿EOS的诊断价值和预后不良评估价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the diagnostic and prognostic evaluation value of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), soluble tumor necrosis factor receptor-II (sTNFR-II) combined with coupling factor-6 (CF-6) in neonatal early-onset sepsis (EOS). Methods: 170 EOS children who were admitted to Shanghai Children's Hospital from January 2021 to January 2023 were selected as EOS group, patients were divided into poor prognosis group and good prognosis group according to the prognosis outcome, and 100 healthy newborns without infection symptoms in our hospital during the same period were selected as control group.The levels of serum sTREM-1, sTNFR-II and CF-6 were detected by enzyme-linked immunosorbent assay. The influencing factors of poor prognosis of neonatal EOS were analyzed by multivariate Logistic regression model, the diagnostic value and poor prognosis evaluation value of serum sTREM-1, sTNFR-II and CF-6 levels in neonatal EOS were analyzed by receiver operating characteristic (ROC) curve. Results: Compared with control group, the levels of serum sTREM-1, sTNFR-II and CF-6 in EOS group were increased (P<0.05). The incidence of poor prognosis in 170 EOS children was 29.41% (50/170). Multivariate Logistic regression model analysis showed that, birth weight≥2.5 kg and platelet count increased were independent protective factors for poor prognosis of neonatal EOS, premature rupture of membranes and sTREM-1 increased, sTNFR-II increased and CF-6 increased were independent risk factors(P<0.05). ROC curve analysis showed that, the area under the curve (AUC) of serum sTREM-1, sTNFR-II combined with CF-6 in the diagnosis of neonatal EOS was 0.943, which was greater than 0.802, 0.821 and 0.816 of sTREM-1, sTNFR-II and CF-6 alone. The AUC of serum sTREM-1, sTNFR-II combined with CF-6 in evaluating the prognosis of neonatal EOS was 0.928, which was greater than 0.774, 0.785 and 0.779 evaluated by sTREM-1, sTNFR-II and CF-6 alone. Conclusion: The levels of serum sTREM-1, sTNFR-II and CF-6 were increased in neonatal EOS, which were closely relate to poor prognosis, the diagnostic value and poor prognosis evaluation value of serum sTREM-1, sTNFR-II combined with CF-6 in neonatal EOS were higher. |
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