新生儿严重细菌感染白介素—6水平变化及临床意义

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－6mRNA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，检测时病程有3天以内的患儿血清IL－6显著高于病程在4天以上者；另检测5例败血症患儿PBMC均见IL－6mRNA的表达，而6例对照新生儿中仅3例有IL－6mRNA表达，按百分位数法初步确定血清IL－6≥23ng/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－6mRNA表达增强，与病情、预后有关，早期检测意义较大。

Changes of IL-6 and Their Clinical Significance in Neonatal Sepsis.

Objective To investigate the clinic value of interleukin 6 (IL 6) in sepsis and septic shock. Methods IL 6 concentrations in the peripheral blood of healthy or infected neonates were determined by ELISA.The expression of IL 6mRNA were also detected by means of RT PCR. Results IL 6 levels of infection group was significant higher than that of control group and IL 6 levels of septic shock group was the highest. All 5 neonates with sepsis had IL 6mRNA expression and 3 of 6 control subject had weak IL 6mRNA expression. The optimal cut off point for diagnostic reference obtained with the percentile was 23ng/L or more, allowing a sensitivity of 81%, and a specificity of 83%. Conclusions Increased IL 6mRNA expression and serum IL 6 levels in the early stage of neonatal sepsis and septic shock are associated with the severity and prognosis of illness. Determination of IL 6 levels seems to be an early indicator of neonatal bacterial infection.