血清白细胞介素-8和C反应蛋白联合测定对新生儿细菌感染诊治的意义  

Significance of Combined Measurement of Serum Interleukin-8 and C-Reactive Protein in Diagnosis and Therapy of Bacterial Infection in Neonates

作　　者：徐发林[1] 万玉[2] 程秀永[3] 

机构地区：[1]郑州大学第三附属医院新生儿科,郑州450052 [2]漯河市中心医院儿科,河南漯河462000 [3]郑州大学第一附属医院儿科,郑州450052

出　　处：《实用儿科临床杂志》2012年第10期747-749,共3页Journal of Applied Clinical Pediatrics

基　　金：河南省医学科技攻关计划项目(200803065)

摘　　要：目的探讨血清IL-8和CRP联合测定对诊断新生儿细菌感染及减少抗生素应用的意义。方法收集出生体质量>1 500 g的新生儿150例,按有无感染分为临床感染组、可疑感染组和对照组,每组各50例。各组患儿入院后均立即采集静脉血2.0 mL,进行血清IL-8、CRP、血常规等检查。临床感染组、可疑感染组在抗生素应用1个疗程(7 d)后,再行血清IL-8、CRP、血常规等检查,以决定是否继续应用抗生素,如需要,则继续应用抗生素7 d后,再行血清IL-8、CRP、血常规等检查,直至痊愈或出院。结果治疗前IL-8、CRP水平临床感染组、可疑感染组显著高于对照组(Pa<0.01),临床感染组显著高于可疑感染组(Pa<0.01);临床感染组治疗7 d、14 d及可疑感染组治疗7 d血清IL-8、CRP水平显著低于治疗前(Pa=0.000)。临床感染组治疗14 d后根据经验使用抗生素率较根据IL-8≥70 ng·L-1和(或)CRP>10 mg·L-1使用抗生素率高出20%,差异有统计学意义(P=0.035);可疑感染组治疗7 d后根据抗生素应用指征使用抗生素率较根据IL-8≥70 ng·L-1和(或)CRP>10 mg·L-1使用抗生素率高出22%,差异有统计学意义(P=0.023)。结论联合测定血清IL-8和CRP水平可早期诊断新生儿感染,以IL-8≥70 ng·L-1和(或)CRP>10 mg·L-1作为诊断新生儿细菌感染的最佳临界值,可减少新生儿不必要的抗生素应用。Objective To analyze the significance of combined measurement of serum interleukin - 8 （ IL - 8 ） and C - reactive protein （CRP） in diagnosis of bacterial infection and reduction of unnecessary antibiotic therapy in neonates. Methods Patients with infection or suspected infection were divided into 3 groups：clinical infection group, suspected infection group and control group, each with 50 cases. Two milliliters of blood samples for determining serum IL - 8, CRP and hematological parameters were collected from all the neonates in this study before starting treatment. Measurement of serum IL - 8 and CRP in the clinical infection group and the suspected infection group were repeated on the 7th and the 14th day of treatment if these were necessary based on their own standard. Results Serum IL - 8 and CRP levels before treatment in the clinical infection group and the suspected infection group were significantly higher than those in control group（ Pa 〈 0.01 ）, while serum IL -8 and CRP levels in the clinical infection group were significantly higher than those in the suspected infection group （P 〈 0.01 ）. Serum IL - 8 and CRP levels after treatment on the 7th day and the 14th day in the clinical infection group and the suspected infection group were significantly lower than those before treatment（ P = 0. 000）. The rate of antibiotic therapy in the clinical infection group based on experience on the 14th day of treatment were 20% higher than that based on the value of IL - 8 ≥70mg·L^-1 and （or） CRP 〉 10 mg·L^-1, and the difference was statistically significant（ P = 0. 035 ）. The rate of antibiotic therapy in the suspected infection group conducted according to the indications for antibiotic therapy on the 7th day of treatment were 22% higher than that based on the value of IL -8 〉170 mg·L^-1 and （or） CRP 〉 10mg·L^-1, and the difference was statistically significant （ P = 0. 023 ）. Conclusion Measurement of serum IL - 8 combined with CRP can diagnose neonatal infecti

关 键 词：白细胞介素-8 C反应蛋白 感染 抗生素 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]