CAJ | 학술논문

目的：探讨健康足月新生儿脐血中提示早发细菌感染的生物标志：超敏C反应蛋白（hs‐CRP）、降钙素原（PCT ）、白细胞介素（IL）‐6、IL‐8、血小板（PLT）、白细胞总数（WBC）在该地区的参考区间。方法搜集2012年1月到2013年10月重庆医科大学附属儿童医院足月新生儿脐带血1476例，最终纳入1191例健康足月新生儿脐血，检测脐血中hs‐CRP、PCT、IL‐6、IL‐8、PLT、WBC的变化，采用SAS9．0处理数据，对相关数据应用上下（上）限进行描述，应用秩和检验分析组间差异。结果正常足月新生儿脐血hs‐CRP参考上限为3．1mg／L，PCT参考上限为为0．18ng／mL。IL‐6、IL‐8参考区间为56．6（11．9～133．2）ng／L、976．0（111．7～2507．1）ng／L，PLT参考区间为242．0（120．0～339．0）×109／L，WBC参考区间为12．9（7．6～19．3）×109／L，脐血血小板值在剖宫产组中较顺产组低（230vs．254，Z＝4．301，P＜0．05），不同孕周，各感染生物学标志差异无统计学意义（P＞0．05）。早发败血症患儿的CRP、PCT升高（P＜0．05），IL‐6、IL‐8、WBC、PLT与健康患儿比较，差异无统计学意义（P＞0．05）。结论该研究建立了健康足月儿脐血中细菌感染生物学标志的参考区间，为新生儿早期细菌感染的诊断奠定了基础。
목적：탐토건강족월신생인제혈중제시조발세균감염적생물표지：초민C반응단백（hs‐CRP）、강개소원（PCT ）、백세포개소（IL）‐6、IL‐8、혈소판（PLT）、백세포총수（WBC）재해지구적삼고구간。방법수집2012년1월도2013년10월중경의과대학부속인동의원족월신생인제대혈1476례，최종납입1191례건강족월신생인제혈，검측제혈중hs‐CRP、PCT、IL‐6、IL‐8、PLT、WBC적변화，채용SAS9．0처리수거，대상관수거응용상하（상）한진행묘술，응용질화검험분석조간차이。결과정상족월신생인제혈hs‐CRP삼고상한위3．1mg／L，PCT삼고상한위위0．18ng／mL。IL‐6、IL‐8삼고구간위56．6（11．9～133．2）ng／L、976．0（111．7～2507．1）ng／L，PLT삼고구간위242．0（120．0～339．0）×109／L，WBC삼고구간위12．9（7．6～19．3）×109／L，제혈혈소판치재부궁산조중교순산조저（230vs．254，Z＝4．301，P＜0．05），불동잉주，각감염생물학표지차이무통계학의의（P＞0．05）。조발패혈증환인적CRP、PCT승고（P＜0．05），IL‐6、IL‐8、WBC、PLT여건강환인비교，차이무통계학의의（P＞0．05）。결론해연구건립료건강족월인제혈중세균감염생물학표지적삼고구간，위신생인조기세균감염적진단전정료기출。
Objective To explore the regional reference intervals of biomarkers in umbilical blood for diagnosis of early onset bacterial infection in the healthy term newborns .Methods The umbilical blood samples were collected from 1 476 term newborns in our hospital during January 2012 to October 2013 ,of which 1 191 were healthy infants and enrolled in this study .Then the levels of high sensitive c‐reaction protein(hs‐CRP) ,procalcitonin(PCT) ,interleukin(IL)‐6 ,IL‐8 ,platelet(PLT) as well as white blood cell (WBC) were detected in the umbilical blood .These values were analyzed by SAS 9 .0 ,data were described through upper or lower limits or upper limits respectively .Differences among different subgroups were judged through analysis of Kruskal‐Wallis t test or Mann‐Whitney test respectively .Results The upper limits for hs‐CRP was 3 .1 mg/L ,for PCT was 0 .18 ng/mL ,while the refer‐ence interval for IL‐6 was 56 .6(11 .9-133 .2)ng/L ,and IL 8 was 976 .0(111 .7-2 507 .1)ng/L ,PLT was 242 .0(120 .0-339 .0)× 109/L and for WBC was 12 .9(7 .6-19 .3 )× 10 9/L ,and the value of PLT varied from vaginal delivery group to caesarean section group(230 vs .254 ,Z= 4 .301 ,P< 0 .05);no significant differences were found in these biomarkers among different gestational week specific groups (P>0 .05) .Otherwise ,compared with the regional reference intervals ,CRP and PCT in early onset neonatal sepsis group increased(P<0 .05) ,no significant difference was found for IL‐6 ,IL‐8 ,WBC and PLT (P>0 .05) .Conclusion The reference intervals of biomarkers in umbilical blood for diagnosis of early onset bacterial infection were established which may make great contribution for early diagnosis of bacterial infection for the newborns .