CAJ | 학술논문

目的　探讨白细胞介素-6(IL-6)在新生儿败血症及败血症休克中的变化及临床意义。方法　采用酶联免疫吸附法(ELISA)检测正常与严重感染新生儿血清IL-6的水平，用逆转录聚合酶链反应(RT-PCR)技术测定外周血单个核细胞(PBMC)IL-6 mRNA表达情况。结果　感染组血清IL-6水平升高，其中败血症性休克组尤为明显，并随病情好转而下降，检测时病程在3 d以内的患儿血清IL-6显著高于病程在4 d以上者；另检测5例败血症患儿PBMC均见IL-6 mRNA的表达，而6例对照新生儿中仅3例有IL-6 mRNA表达。按百分位数法初步确定血清IL-6≥23 ng/L为诊断新生儿败血症的参考指标，此指标敏感性为81%，特异性为83%。结论　新生儿败血症及败血症休克早期血清IL-6水平升高、IL-6 mRNA表达增强，与病情、预后有关，早期检测意义较大。
목적　탐토백세포개소-6(IL-6)재신생인패혈증급패혈증휴극중적변화급림상의의。방법　채용매련면역흡부법(ELISA)검측정상여엄중감염신생인혈청IL-6적수평，용역전록취합매련반응(RT-PCR)기술측정외주혈단개핵세포(PBMC)IL-6 mRNA표체정황。결과　감염조혈청IL-6수평승고，기중패혈증성휴극조우위명현，병수병정호전이하강，검측시병정재3 d이내적환인혈청IL-6현저고우병정재4 d이상자；령검측5례패혈증환인PBMC균견IL-6 mRNA적표체，이6례대조신생인중부3례유IL-6 mRNA표체。안백분위수법초보학정혈청IL-6≥23 ng/L위진단신생인패혈증적삼고지표，차지표민감성위81%，특이성위83%。결론　신생인패혈증급패혈증휴극조기혈청IL-6수평승고、IL-6 mRNA표체증강，여병정、예후유관，조기검측의의교대。
Objective　To investigate the clinic value of interleukin-6 (IL-6) in sepsis and septic shock. Method　IL-6 concentrations in the peripheral blood of healthy or infected neonates were determined by ELISA. The expression of IL-6 mRNA were also detected by means or RT-PCR. Result　IL-6 levels of infection group were significant higher than that of control group and IL-6 levels of septic shock group were the highest. All 5 neonates with sepsis had IL-6 mRNA expression and 3 of 6 control subjects had weak IL-6 mRNA expression. The optimal cut off point for diagnostic reference obtained with the percentile was 23 ng/L or more, allowing a sensitivity of 81%, and a specificity of 83%. Conclusion　Increased IL-6 mRNA expression and serum IL-6 levels in the early stage of neonatal sepsis and septic shock are associated with the severity and outcome of illness. Determination of IL-6 levels seems to be an early indicator of neonatal bacterial infection.