炎症因子水平对新生儿B族链球菌败血症的诊断价值

目的分析外周血降钙素原(PCT)、血小板计数(PLT)、C-反应蛋白(CRP)及白细胞介素-6(IL-6)水平对新生儿B族链球菌(GBS)败血症的诊断价值,为临床诊断工作提供研究依据。方法选取2018年1月-2019年12月于三亚中心医院就诊的116例新生儿败血症患儿作为研究对象,根据血培养结果分为研究组(GBS感染,33例)和对照组(非GBS感染,83例)。对两组患儿的一般临床资料、临床症状、孕产妇情况及外周血PCT、PLT、CRP、IL-6水平进行分析。结果研究组孕产妇中胎膜早破、既往GBS感染占比分别为45.45%(15/33)、42.42%(14/33)高于对照组(P<0.05)。研究组患儿血清PCT、CRP、IL-6分别为(6.80±3.65)μg/L、(47.45±25.98)mg/L、(76.33±26.67)ng/L均高于对照组,而外周血PLT为(207.49±103.55)×109/L低于对照组(P<0.05)。血清PCT、IL-6水平和PLT水平诊断新生儿GBS败血症的受试者工作特征曲线下面积(AUC)均有统计学意义(P<0.05),分别为0.672、0.717、0.643,而血清CRP诊断新生儿GBS败血症的AUC无统计学意义(P=0.072)。结论与非GBS败血症比较,新生儿GBS败血症可表现为较高的PCT、CRP、IL-6水平和较低的PLT水平,其中,血清PCT、IL-6和PLT水平对于GBS败血症具有一定的辅助诊断价值。

Diagnostic values of inflammatory factors for neonatal group B Streptococcus septicemia

OBJECTIVE To analyze the levels of peripheral blood procalcitonin(PCT), platelet count(PLT), C-reactive protein(CRP) and interleukin-6(IL-6) in the diagnosis of neoatal group B Streptococcus(GBS) septicemia, so as to provide research basis for clinical diagnosis. METHODS A total of 116 newborns with septicemia who were treated in Sanya Central Hospital from Jan. 2018 to Dec. 2019 were selected as the study subjects, and were divided into a study group(with GBS infection, 33 cases) and a control group(without GBS infection, 83 cases) according to the results of blood culture. The general clinical data, the clinical symptoms, the maternal status and the levels of PCT, PLT, CRP and IL-6 in peripheral blood of the two groups of children were compared and analyzed. RESULTS The proportions of premature rupture of membranes and previous GBS infection in pregnant women in the study group were 45.45%(15/33) and 42.42%(14/33), respectively, significantly higher than those in the control group(P<0.05). The serum PCT, CRP and IL-6 of the newborns in the study group were(6.80±3.65)μg/L,(47.45±25.98)mg/L and(76.33±26.67) ng/L, respectively, significantly higher than those in the control group, while the level of PLT in the peripheral blood was(207.49±103.55)×109/L, which was significantly lower than that in the control group(P<0.05). The areas under the receiver characteristic curve(AUCROC) of the serum PCT, IL-6 and PLT levels in the diagnosis of GBS septicemia were significant(P<0.05), which were 0.672, 0.717 and 0.643, respectively, while AUCROC of the serum CRP in the diagnosis of GBS septicemia was not significant(P=0.072). CONCLUSION Compared with those with non-GBS septicemia, the newborns with GBS septicemia showed higher PCT, CRP, IL-6 levels and lower PLT level. Among them, the serum PCT, IL-6 levels and PLT level had certain auxiliary diagnostic values for GBS septicemia.