IL-6、PCT、hs-CRP和WBC在新生儿细菌感染性疾病早期诊断中的价值

The value of interleukin-6, procalcitonin, high-sensitivity C-reactive protein and white blood cell count in the early diagnosis of neonatal bacterial infection

摘要:

目的 深入探讨白细胞介素-6（IL-6）、血清降钙素原（PCT）、超敏C反应蛋白（hs-CRP）和白细胞计数（WBC）在新生儿细菌感染性疾病早期诊断中的价值，为临床采取及时有效的治疗措施提供科学依据。方法 选取2018年6月—2018年10月在山东第一医科大学第二附属医院新生儿科住院诊断为细菌感染性疾病的69例新生儿作为感染组。选取同期该院收治的非感染性疾病的45例新生儿作为对照组。比较两组新生儿血清IL-6、hs-CRP、PCT和WBC水平，比较各指标诊断新生儿细菌感染性疾病的受试者工作特征（ROC）曲线下面积及敏感性、特异性。结果 两组患儿性别构成比、日龄、胎龄及出生时体重比较，差异无统计学意义（P >0.05）。感染组WBC、hs-CRP、PCT和IL-6水平高于对照组（P <0.05）。感染组WBC、hs-CRP、PCT和IL-6阳性率高于对照组（P <0.05）。各指标计算敏感性和特异性并绘制ROC曲线，IL-6约登指数和曲线下面积最大，分别为0.743和0.967，联合检测中WBC+hs-CRP特异性最高（82.22%），PCT+IL-6+WBC+hs-CRP敏感性最高（98.55%），IL-6+WBC+hs-CRP约登指数最高（0.720）。结论 IL-6、PCT、hs-CRP、WBC的检测在新生儿细菌感染性疾病的早期诊断中都具有一定的意义，采用IL-6+WBC+hs-CRP联合检测可以在不同临床表现的新生儿细菌感染性的早期诊断中发挥重要作用。

Abstract:

Objective To deeply explore the value of interleukin-6 (IL-6), serum procalcitonin (PCT), high-sensitive C-reactive protein (hs-CRP) and white blood cell (WBC) count in the early diagnosis of neonatal bacterial infection, so as to provide scientific evidence for effective and timely clinical treatment.Methods A total of 69 neonates with bacterial infectious diseases admitted to the Second Affiliated Hospital of Shandong First Medical University from June 2018 to October 2018 were selected as the infection group, while 45 neonates without bacterial infectious diseases in the hospital during the same time were enrolled as the control group. The serum levels of IL-6, hs-CRP, and PCT as well as WBC count were compared between the two groups, and the areas under the receiver operating characteristic (ROC) curve, sensitivity and specificity of each indicator for the diagnosis of neonatal bacterial infection were also analyzed.Results There was no difference in the sex ratio, days of age, gestational age or birth weight between the two groups of neonates (P > 0.05). The WBC count and the levels of IL-6, PCT, and hs-CRP in the infection group were higher than those in the control group (P < 0.05). The positive rates of the WBC count, IL-6, PCT, and hs-CRP in the infection group were also higher than those in the control group (P < 0.05). In the ROC analysis, compared with other indicators, the Youden index (0.743) and the area under the ROC (AUC) curve (0.967) of IL-6 were the highest, respectively. As for the combination detection, the specificity of WBC combined with hs-CRP (82.22%), the sensitivity of PCT, IL-6, WBC combined with hs-CRP (98.55%), and the Youden index of IL-6, WBC combined with hs-CRP were the highest, respectively.Conclusions The detection of IL-6, PCT, hs-CRP, and WBC count is of certain significance in the early diagnosis of neonatal bacterial infection. Specifically, the combined detection of different indicators may play an important role in early diagnosing neonatal bacterial infection with all sorts of clinical manifestations.