Clinical Value of Different Biochemical Markers in Diagnosing Fetal Sepsis in Premature Neonates_West China Medical Journal

Authors：

 SHIWei ,  CHENChang-hui

Department of Pediatrics, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding?author：

CHENChang-hui, Email: changfhuichen@163.com

Keywords：

Biochemical markers; Procalcitonin; C-reactive protein; Interleukin-6; Premature neonates; Fetal sepsis

DOI：

10.7507/1002-0179.20140451

Video：

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Objective To examine and compare the value of procalcitonin (PCT), C-reactive protein (CRP) and interleukin (IL)-6 in diagnosing fetal sepsis in premature neonates. Methods Preterm neonates with premature rupture of membrane between January 2010 and September 2012 were screened, and the serum levels of PCT, CRP and IL-6 were detected in the first day of life. All preterm neonates were divided into two groups according to the development of sepsis (45 cases with sepsis and 39 cases without sepsis). Results The levels of PCT, CRP and IL-6 in premature neonates with sepsis were all significantly higher than those without sepsis. The cut-off value of PCT in diagnosis of sepsis was 2.14 μg/L, with a sensitivity and specificity of 76% and 85% respectively; the cut-off value of CRP in diagnosis of sepsis was 7.90 mg/L, with a sensitivity and specificity of 67% and 61% respectively. For IL-6, the cut-off value in diagnosis of sepsis was 13.80 ng/L, and its sensitivity and specificity were high to 90% and 94%, respectively. Conclusion IL-6 is the most reliable biochemical marker for the detection of early-onset sepsis in preterm neonates with premature rupture of membrane.

Citation： SHIWei, CHENChang-hui. Clinical Value of Different Biochemical Markers in Diagnosing Fetal Sepsis in Premature Neonates. West China Medical Journal, 2014, 29(8): 1469-1471. doi: 10.7507/1002-0179.20140451 Copy

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13.	饒麗娟, 周秋蓮. 孕婦血清和羊水中IL-8、MMP-9檢測在診斷胎膜早破并絨毛膜羊膜炎中的價值[J]. 醫學臨床研究, 2009, 26(4):637-639.
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15.	戴標. IL-6、CRP和CD64在新生兒感染性疾病診斷中的價值[J]. 江蘇大學學報·醫學版, 2012, 22(5):434-436.
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1. 姜毅. 新生兒敗血癥診療進展[J]. 中國新生兒科雜志, 2010, 25(2):69-72.
2. 馮琪. 新生兒膿毒癥診斷與治療[J]. 中國實用兒科雜志, 2011, 26(12):902-906.
3. 張謙慎. 北美新生兒早發敗血癥的評估和抗生素治療[J]. 中國新生兒科雜志, 2012, 27(4):284-286.
4. Ng PC, Lam HS. Biomarkers for late-onset neonatal sepsis:cytokines and beyond[J]. Clin Perinatol, 2010, 37(3):599-610.
5. Bender L, Thaarup J, Varming K, et al. Early and late markers for the detection of early-onset neonatal sepsis[J]. Dan Med Bull, 2008, 55(4):219-223.
6. 郝玲, 任常軍, 王炳輝, 等. CD64、降鈣素原在新生兒敗血癥診斷中的價值[J]. 臨床兒科雜志, 2011, 29(3):216-218.
7. 歐陽穎, 梁立陽, 蘇浩彬, 等. 新生兒敗血癥病原學分析[J]. 中國新生兒科雜志, 2007, 22(5):302-303.
8. 吳華, 卿文衡, 楊良勇. 血培養聯合降鈣素原與超敏C反應蛋白在新生兒敗血癥早期診斷中的應用[J]. 檢驗醫學與臨床, 2010, 7(21):2328-2329.
9. 魏東, 黃紹敏. 新生兒敗血癥單個核細胞產生腫瘤壞死因子α的能力及意義[J]. 實用兒科臨床雜志, 1998, 13(4):191-192.
10. 王今達, 雪琳. 細菌、內毒素、炎性介質并治——治療重癥膿毒病的新對策[J]. 中國危重病急救醫學, 1998, 10(6):5-7.
11. 齊文清. 白細胞介素6、白細胞介素8在新生兒敗血癥診斷中的價值[J]. 中國社區醫師·醫學專業, 2012, 14(14):124.
12. Lam HS, Ng PC. Biochemical markers of neonatal sepsis[J]. Pathology, 2008, 40(2):141-148.
13. 饒麗娟, 周秋蓮. 孕婦血清和羊水中IL-8、MMP-9檢測在診斷胎膜早破并絨毛膜羊膜炎中的價值[J]. 醫學臨床研究, 2009, 26(4):637-639.
14. 金勝鑫, 石海礬, 李偉. 血清降鈣素原與超敏C反應蛋白及白介素6在新生兒早期感染中的診斷價值[J]. 中華醫院感染學雜志, 2013, 23(7):1600-1601.
15. 戴標. IL-6、CRP和CD64在新生兒感染性疾病診斷中的價值[J]. 江蘇大學學報·醫學版, 2012, 22(5):434-436.
16. Muller B, White JC, Nylen ES, et al. Ubiquitous expression of the calcitonin-I gene in multiple tissues in response to sepsis[J]. J Clin Endocrinol Metab, 2001, 86(1):396-404.
17. 李貴霞, 馬莉, 張麗霞. 新生兒敗血癥降鈣素原和C反應蛋白檢測及臨床意義[J]. 檢驗醫學, 2005, 20(3):250-252.

West China Medical Journal

Clinical Value of Different Biochemical Markers in Diagnosing Fetal Sepsis in Premature Neonates

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