| 胡婷,刘悦.血清粒细胞巨噬细胞集落刺激因子、人中性粒细胞多肽 1-3、 CD64联合预测新生儿败血症抗感染转归的价值[J].安徽医药,2023,27(9):1791-1795. |
| 血清粒细胞巨噬细胞集落刺激因子、人中性粒细胞多肽 1-3、 CD64联合预测新生儿败血症抗感染转归的价值 |
| The value of serum GM-CSF, HNP1-3 and CD64 combined to predict anti-infective regression in neonatal sepsis |
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| DOI：10.3969/j.issn.1009-6469.2023.09.021 |
| 中文关键词: 新生儿脓毒症 抗感染 粒细胞巨噬细胞集落刺激因子 人中性粒细胞多肽 1-3 CD64 预测价值 |
| 英文关键词: Neonatal sepsis Anti-infection Granulocyte-macrophage colony-stimulating factor Human neutrophil polypeptide 1-3 CD64 Predictive value |
| 基金项目:陕西省医学科学研究课题计划项目( 2017JM2819) |
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| 中文摘要: |
| 目的探讨血清粒细胞巨噬细胞集落刺激因子( GM-CSF)、人中性粒细胞多肽 1-3(HNP1-3)、中性粒细胞表面抗原 CD64联合预测新生儿败血症抗感染转归结局及预防措施。方法选取三二〇一医院 2019年 1月至 2021年 10月新生儿败血症病儿 92例作为研究对象，均行抗感染治疗，治疗 7d后根据抗感染转归结局分为有效组( 69例)与无效组( 23例)。比较两组血清 GM-CSF、HNP1-3、CD64水平，分析各血清指标预测抗感染转归结局的预测价值。结果无效组血清 GM-CSF(0.24±0.08) μg/L、HNP1-3(92.75±17.22)μg/L、CD64(1 281.00±89.04)平均荧光强度( MFI)高于有效组( 0.17±0.05)μg/L、(78.40±14.16)μg/L、(362.00±82.37)MFI(P<0.05)；血清 GM-CSF、HNP1-3、CD64水平与新生儿败血症病情程度呈正相关( P<0.05)； logistic回归分析，校正前，病情程度、低体质量儿、早产、合并化脓性脑膜炎、血清 GM-CSF、HNP1-3、CD64对新生儿败血症抗感染转归结局有独立影响，校正病情程度、低体质量儿、早产、合并化脓性脑膜炎等其他因素后，血清 GM-CSF、HNP1-3、CD64仍对新生儿败血症抗感染转归结局有独立影响( P<0.05)；血清 GM-CSF、HNP1-3、CD64联合预测新生儿抗感染转归结局的 AUC为 0.91［95%CI:(0.83，0.96)］大于各指标单独预测 0.84［95%CI:(0.75，0.91)］、 0.80［95%CI:(0.70，0.87)］、 0.77［95%CI:(0.67，0.85)］灵敏度为 91.30%，度为 81.16%。结论血清 GM-CSF、HNP1-3、CD64联合预测新生儿败血症抗感染转归结局的价值较可靠，临床可根据其血清水平变化制定相关防治措施，同时还应关注病情程度、低体质量儿、早产、合并化脓性脑膜炎等因素对抗感特异，为染转归结局的影响。 |
| 英文摘要: |
| Objective To investigate the combination of serum granulocyte-macrophage colony-stimulating factor (GM-CSF), human neutrophil polypeptide 1-3 (HNP1-3) and neutrophil surface antigen CD64 in predicting the outcome of anti-infective regression and preventive measures in neonatal sepsis.Methods A total of 92 children with neonatal sepsis in the 3201 Hospital from January 2019to October 2021 were selected as the research subjects, and all of them were treated with anti-infective therapy and were divided intoan effective group (69 cases) and an ineffective group (23 cases) according to the outcome of anti-infection regression after 7 d of treat- ment. The serum levels of GM-CSF, HNP1-3 and CD64 were compared between the two groups, and the predictive value of each serum index in predicting the outcome of anti-infection regression was analyzed. Results The mean fluorescence intensity (MFI) of serum GM-CSF, HNP1-3 and CD64 in the ineffective group were (0.24±0.08) μg/L, (92.75±17.22) μg/L, and (1 281.00±89.04) MFI, respec-tively, which were higher than those in the effective group [(0.17±0.05) μg/L, (78.40±14.16) μg/L, (362.00±82.37) MFI] (P<0.05); se- rum GM-CSF, HNP1-3 and CD64 levels were positively correlated with the degree of neonatal sepsis condition (P<0.05); and logistic re-gression analysis of precorrection degree of illness, low body mass children, preterm birth, combined purulent meningitis, serum GMCSF, HNP1-3, CD64 had independent effects on the outcome of neonatal sepsis anti-infection regression, after correcting for other fac-tors such as degree of illness, low body mass children, preterm birth, combined purulent meningitis, serum GM-CSF, HNP1-3, CD64 still had an independent effect on the outcome of neonatal sepsis anti-infection regression (P<0.05); the AUC of serum GM-CSF, HNP13, and CD64 combined to predict the outcome of neonatal anti-infective regression was 0.91 [95% CI: (0.83, 0.96)], which was greater than the individual prediction of each metric alone of 0.84 [95% CI: (0.75, 0.91)], 0.80 [95% CI: (0.70, 0.87)], and 0.77 [95% CI: (0.67, 0.85)], with a sensitivity of 91.30% and a specificity of 81.16%.Conclusions The values of serum GM-CSF, HNP1-3 and CD64 are re- liable in predicting the outcome of anti-infection regression in neonatal sepsis. Clinical measures can be formulated according to thechange in serum levels, and the influence of disease degree, low birth weight infants, prematurity, and the combination of purulent men-ingitis on the outcome of anti-infective regression should also be emphasized. |
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