中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2011年
5期
261-266
,共6页
细菌感染%膜糖蛋白类%受体,免疫%婴儿,新生
細菌感染%膜糖蛋白類%受體,免疫%嬰兒,新生
세균감염%막당단백류%수체,면역%영인,신생
Bacterial infections%Membrane glycoproteins%Receptors,immunologic%Infant,newborn
目的 检测感染新生儿血清可溶性髓样细胞触发受体-1(soluble form of triggering receptors expressed on myeloid cell-1,sTREM-1)的水平,探讨sTREM-1在足月新生儿感染中的变化及其意义.方法 以上海交通大学附属儿童医院新生儿科85例足月新生儿为研究对象,根据感染情况分为重症感染组(27例),轻症感染组(28例)和非感染组(30例).感染组患儿在出现感染症状48 h内使用抗生素前采集静脉血1 ml;非感染组患儿在住院期间采集静脉血1 ml.重症感染组中合并器官功能障碍的患儿在出现感染症状的第3和7天再次采集静脉血各1 ml.采用酶联免疫吸附试验测定血清中sTREM-1水平,并采用方差分析进行组间比较.绘制受试者工作特性曲线确定sTREM-1的最佳界值,计算敏感性、特异性、阳性预测值、阴性预测值和约登指数.结果 (1)重症感染组sTREM-1水平为(91.2±47.3)pg/ml,高于轻症感染组[(68.8±30.4)pg/ml],轻症感染组又高于非感染组E(35.5±17.6)pg/ml],差异均有统计学意义(P均=0.000).(2)重症感染组中有17例存活,10例死亡;死亡患儿血清sTREM-1水平为(121.6±49.3)pg/ml,明显高于存活者[(73.1±34.9)pg/ml],差异有统计学意义(t=2.995,P=0.006).(3)重症感染组合并器官功能障碍的13例患儿中,存活者感染第1周内血清sTREM-1水平总体呈下降趋势,死亡患儿sTREM-1水平呈上升趋势,最佳界值为100.6 pg/ml.(4)将sTREM-1≥43.8 pg/ml作为阳性诊断标准,其曲线下面积为0.868,敏感性、特异性、阳性和阴性预测值及约登指数分别为85.5%、80.0%、0.887、0.750和0.655.结论 血清sTREM-1水平在新生儿感染时升高;重症感染患儿血清sTREM-1水平呈动态变化,其变化趋势可能与预后有关.
目的 檢測感染新生兒血清可溶性髓樣細胞觸髮受體-1(soluble form of triggering receptors expressed on myeloid cell-1,sTREM-1)的水平,探討sTREM-1在足月新生兒感染中的變化及其意義.方法 以上海交通大學附屬兒童醫院新生兒科85例足月新生兒為研究對象,根據感染情況分為重癥感染組(27例),輕癥感染組(28例)和非感染組(30例).感染組患兒在齣現感染癥狀48 h內使用抗生素前採集靜脈血1 ml;非感染組患兒在住院期間採集靜脈血1 ml.重癥感染組中閤併器官功能障礙的患兒在齣現感染癥狀的第3和7天再次採集靜脈血各1 ml.採用酶聯免疫吸附試驗測定血清中sTREM-1水平,併採用方差分析進行組間比較.繪製受試者工作特性麯線確定sTREM-1的最佳界值,計算敏感性、特異性、暘性預測值、陰性預測值和約登指數.結果 (1)重癥感染組sTREM-1水平為(91.2±47.3)pg/ml,高于輕癥感染組[(68.8±30.4)pg/ml],輕癥感染組又高于非感染組E(35.5±17.6)pg/ml],差異均有統計學意義(P均=0.000).(2)重癥感染組中有17例存活,10例死亡;死亡患兒血清sTREM-1水平為(121.6±49.3)pg/ml,明顯高于存活者[(73.1±34.9)pg/ml],差異有統計學意義(t=2.995,P=0.006).(3)重癥感染組閤併器官功能障礙的13例患兒中,存活者感染第1週內血清sTREM-1水平總體呈下降趨勢,死亡患兒sTREM-1水平呈上升趨勢,最佳界值為100.6 pg/ml.(4)將sTREM-1≥43.8 pg/ml作為暘性診斷標準,其麯線下麵積為0.868,敏感性、特異性、暘性和陰性預測值及約登指數分彆為85.5%、80.0%、0.887、0.750和0.655.結論 血清sTREM-1水平在新生兒感染時升高;重癥感染患兒血清sTREM-1水平呈動態變化,其變化趨勢可能與預後有關.
목적 검측감염신생인혈청가용성수양세포촉발수체-1(soluble form of triggering receptors expressed on myeloid cell-1,sTREM-1)적수평,탐토sTREM-1재족월신생인감염중적변화급기의의.방법 이상해교통대학부속인동의원신생인과85례족월신생인위연구대상,근거감염정황분위중증감염조(27례),경증감염조(28례)화비감염조(30례).감염조환인재출현감염증상48 h내사용항생소전채집정맥혈1 ml;비감염조환인재주원기간채집정맥혈1 ml.중증감염조중합병기관공능장애적환인재출현감염증상적제3화7천재차채집정맥혈각1 ml.채용매련면역흡부시험측정혈청중sTREM-1수평,병채용방차분석진행조간비교.회제수시자공작특성곡선학정sTREM-1적최가계치,계산민감성、특이성、양성예측치、음성예측치화약등지수.결과 (1)중증감염조sTREM-1수평위(91.2±47.3)pg/ml,고우경증감염조[(68.8±30.4)pg/ml],경증감염조우고우비감염조E(35.5±17.6)pg/ml],차이균유통계학의의(P균=0.000).(2)중증감염조중유17례존활,10례사망;사망환인혈청sTREM-1수평위(121.6±49.3)pg/ml,명현고우존활자[(73.1±34.9)pg/ml],차이유통계학의의(t=2.995,P=0.006).(3)중증감염조합병기관공능장애적13례환인중,존활자감염제1주내혈청sTREM-1수평총체정하강추세,사망환인sTREM-1수평정상승추세,최가계치위100.6 pg/ml.(4)장sTREM-1≥43.8 pg/ml작위양성진단표준,기곡선하면적위0.868,민감성、특이성、양성화음성예측치급약등지수분별위85.5%、80.0%、0.887、0.750화0.655.결론 혈청sTREM-1수평재신생인감염시승고;중증감염환인혈청sTREM-1수평정동태변화,기변화추세가능여예후유관.
Objective To observe the changes of serum soluble form of triggering receptors expressed on myeloid cell-1 (sTREM-1) level in full-term newborns with infection and to investigate the relationship between serum sTREM-1 and neonatal bacterial infection.Methods Eighty-five full-term newborns admitted to the neonatal ward of Shanghai Children s Hospital of Shanghai Jiaotong University were selected into this study.According to the locations and severity of infection,patients were divided into 3 groups: severe infection group (n = 27),mild infection group (n = 28),non-infection group (n = 30).The samples of infection groups were collected before using antibiotics and within 48 h after infection symptom occurred; others were collected during hospitalization.For the neonates with organ dysfunction in the severe infection group,samples were also collected at the third and seventh day of infection.Serum sTREM-1 was measured by enzyme-linked immunosorbent assay.Analysis of variance was used to compare the difference between groups.Receiver operating characteristic (ROC) curve was used to calculate the sensitivity,specificity,positive and negative predictive value and Youden index.Results (1) Serum sTREM-1 level of severe infection group[(91.2±47.3) pg/ml] was significantly higher than that of mild infection group[(68.8 + 30.4) pg/ml] and non-infection group[(35.5±17.6) pg/ml],respectively (P＜0.05).(2) Serum sTREM-1 level of the survival newborns (n= 17) in the severe infection group was lower than that of dead ones[(73.1±34.9) pg/ml vs (121.6±49.3) pg/ml,t= - 2.995,P = 0.006].(3) For the survival patients,the serum sTREM-1 level decreased in the first week of infection,while that of dead patients increased,the cut-off value was 100.6 pg/ml.(4) Based on the ROC analysis,43.8 pg/ml was selected as the the cut-off value,area under the curve was 0.868,and sensitivity was 85.5%,specificity 80.0%,positive predictive value 0.887,negative predictive value 0.750,Youden index 0.655.Conclusions Serum sTREM-1 level increases in neonatal infection.The change of serum sTREM-1 level in patients with severe infection is correlated to the prognosis.
