| 于乔,陆田田.CXC类趋化因子配体 1和配体 5对新生儿脑膜炎近期预后不良的预测分析[J].安徽医药,2025,29(8):1565-1572. |
| CXC类趋化因子配体 1和配体 5对新生儿脑膜炎近期预后不良的预测分析 |
| Predictive analysis of CXCL1 and CXCL 5 for short-term poor prognosis in neonatal meningitis |
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| DOI：10.3969/j.issn.1009-6469.2025.08.016 |
| 中文关键词: 新生儿脑膜炎 CXC类趋化因子配体 1 CXC类趋化因子配体 5 C反应蛋白 预后 |
| 英文关键词: Neonatal meningitis CXC motif chemokine ligand 1 CXC motif chemokine ligand 5 C-reactive protein Prognosis |
| 基金项目:宿迁市市级指导性科技计划项目( Z2021106) |
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| 中文摘要: |
| 目的探讨 CXC类趋化因子配体 1(CXCL1)、 CXC类趋化因子配体 5(CXCL5)对新生儿脑膜炎近期预后不良的预测价值。方法选取 2021年 7月至 2023年 6月南京鼓楼医院集团宿迁医院新生儿病房收治的 126例细菌性脑膜炎新生儿为研究对象，均于治疗前检测外周血及脑脊液 CXCL1、CXCL5水平。另随访 3个月，根据预后评估结果将病儿分为预后良好组与预后不良组。比较两组病儿 CXCL1、CXCL5水平及一般资料；采用多因素 logistic回归分析筛选新生儿脑膜炎近期预后不良的危险因素，同时通过受试者操作特征曲线( ROC曲线)分析 CXCL1、CXCL5水平及其恢复正常时间对病儿近期预后不良的预测价值。结果纳入研究的 126例病儿中，有 1例中途退出，有 2例失访，最终有 123例病儿进行数据分析； 123例病儿预后不良率为 23.58%(29/123)；预后不良组外周血与脑脊液 CXCL1、CXCL5水平［外周血:(23.77±4.77)μg/L、(82.82±7.00)μg/L；脑脊液: |
| 英文摘要: |
| Objective To explore the predictive value of CXC motif chemokine ligand 1 (CXCL1) and CXC motif chemokine ligand 5 (CXCL5) for short-term poor prognosis in neonatal meningitis.Methods This study included 126 newborns with bacterial meningitisadmitted to the neonatal ward of Nanjing Gulou Hospital Group Suqian Hospital from July 2021 to June 2023. Pretreatment CXCL1 andCXCL5 levels in peripheral blood and cerebrospinal fluid (CSF) were measured. Patients were followed for 3 months and categorized in-to good or poor prognosis groups based on clinical outcomes. CXCL1 and CXCL5 levels and clinical data were compared betweengroups. Multivariate logistic regression identified risk factors for poor prognosis, and receiver operating characteristic (ROC) curvesevaluated the predictive performance of CXCL1 and CXCL5 levels and their normalization time.Results Among 126 patients, 123 were analyzed (1 withdrew, 2 lost to follow-up). The poor prognosis rate was 23.58% (29/123). The levels of CXCL1 and CXCL5 in pe-ripheral blood and cerebrospinal fluid of the poor prognosis group [peripheral blood: (23.77±4.77) μg/L, (82.82±7.00) μg/L; Cerebrospi-nal fluid: (39.06±6.60) μg/L, (102.36±8.58) μg/L] were both higher than those in the good prognosis group [(19.76±3.19) μg/L, (76.06±6.53) μg/L; (32.75±4.97) μg/L, (92.34±7.76) μg/L] (P<0.05),the recovery time of peripheral blood/cerebrospinal fluid CXCL1 and CX-CL5 in the poor prognosis group was longer than that in the good prognosis group (P<0.05). Multivariate logistic regression analysisshowed that high peripheral blood CXCL1 and CXCL5, high cerebrospinal fluid CXCL1 and CXCL5, long recovery time of peripheralblood CXCL1 and CXCL5, long recovery time of cerebrospinal fluid CXCL1 and CXCL5, high cerebrospinal fluid total protein content,high neutrophil to lymphocyte ratio (NLR), high C-reactive protein (CRP), and disease duration>1 day at admission, abnormal headmagnetic resonance imaging (MRI), abnormal electroencephalogram, and cerebrospinal fluid recovery time ≥ 14 days are all risk factorsfor poor prognosis of neonatal meningitis (P<0.05), high cerebrospinal fluid glucose concentration is its protective factor (P<0.05). Ac-cording to ROC curve analysis, the combined prediction of peripheral blood CXCL1 and CXCL5 for short-term poor prognosis in neona-tal meningitis had a sensitivity of 89.66%, specificity of 81.91%, and area under the curve (AUC) of 0.90. For CSF CXCL1 and CXCL5,the combined prediction had a sensitivity of 93.10%, specificity of 84.04%, and AUC of 0.93. The sensitivity and AUC of combined pre-diction were higher than those of individual predictions (P<0.05), while the specificity was similar to individual predictions. The time tonormalization of CXCL1 and CXCL5 levels in peripheral blood and CSF also showed good predictive value for short-term poor progno-sis, with sensitivities of 75.86%, 79.31%, 82.76%, and 86.21%, specificities of 90.43%, 90.43%, 91.49%, and 91.49%, and AUC val-ues of 0.81, 0.81, 0.85, and 0.85, respectively. Conclusions Elevated levels of CXCL1 and CXCL5 are associated with short-term poor prognosis in neonatal meningitis. Both markers can effectively predict adverse outcomes, with improved performance when used incombination. Additionally, the time to normalization of CXCL1 and CXCL5 levels in peripheral blood and CSF serves as a useful indica-tor for predicting short-term poor prognosis in neonatal meningitis, offering guidance for clinical treatment and prognosis evaluation. |
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