肝素结合蛋白和正五聚蛋白3在新生儿细菌感染性疾病诊断中的价值  

Diagnostic value of plasma heparin-binding protein and pentraxin 3 in neonatal bacterial infection diseases

作　　者：任玮[1] 姚宝珍[2] 李艳[1] Ren Wei;Yao Baozhen;Li Yan(Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China;Pediatric Department, Renmin Hospital of Wuhan University, Wuhan 430060, China)

机构地区：[1]武汉大学人民医院检验医学中心,武汉430060 [2]武汉大学人民医院儿科,武汉430060

出　　处：《中华检验医学杂志》2018年第12期943-947,共5页Chinese Journal of Laboratory Medicine

摘　　要：目的探讨肝素结合蛋白(HBP)和正五聚蛋白3 (PTX3)对新生儿细菌感染性疾病的临床诊断价值。方法采用回顾性分析方法,选取2017年3月至11月武汉大学人民医院新生儿科30例新生儿脓毒症(脓毒症组)、84例局部细菌感染新生儿(一般感染组)及50例单纯高胆红素血症新生儿(对照组)。一般感染组和脓毒症组的114例细菌感染新生儿中,有39例合并休克(休克组),75例未合并休克(非休克组)。分别采用免疫比浊法和双位点夹心酶联免疫吸附实验测定HBP和PTX3水平,并收集血清降钙素原(PCT)及全血白细胞(WBC)计数等实验室检查数据。非正态分布数据的比较采用非参数检验,各指标诊断性能比较采用受试者工作特征曲线(ROC),各指标相关性分析采用Pearson相关系数。结果脓毒症组、一般感染组和对照组HBP值分别为(64.41±78.51)ng/ml、(47.16±50.59)ng/ml、(31.97±20.76)ng/ml,PTX3值分别为(2.23±1.44)ng/ml、(1.76±0.94)ng/ml、(1.26±0.66)ng/ml,PCT值分别为(31.92±36.65)ng/ml、(7.72±9.28)ng/ml、(1.87±5.02)ng/ml。脓毒症组PTX3、PCT水平显著高于一般感染组(Z=3.74,Z=5.01,P均<0.05);也显著高于对照组(Z=3.98,Z=5.20,P均<0.05)。脓毒症组HBP水平高于一般感染组,但差异无统计学意义(Z=1.16,P>0.05);也高于对照组,差异有统计学意义(Z=2.37,P<0.05)。休克组PTX3和PCT水平显著高于非休克组(Z=2.20,Z=3.70,P均<0.05);休克组HBP水平高于非休克组,但差异无统计学意义(Z=0.37,P>0.05)。HBP、PTX3、PCT诊断新生儿细菌感染性疾病曲线下面积(AUC)分别为0.683、0.802、0.869;HBP、PTX3、PCT三者联合诊断优于单指标诊断,AUC最大为0.910。PTX3与PCT呈正相关(r=0.242,P<0.05)。结论PTX3和PCT能有效辅助临床诊断新生儿细菌感染性疾病,联合PTX3、PCT和HBP诊断优于单指标诊断。Objective To evaluate the diagnosis value of heparin-binding protein (HBP) and pentraxin 3 (PTX3) in neonatal bacterial infectious diseases.Methods A retrospective study was conducted on 30 septic neonatal as neonatal sepsis group and 84 local infection neonatal as general infection group from May to November 2017 in Renmin Hospital of Wuhan University. It also selected 50 high bilirubin hematic disease but without infection or shock neonatal (control group). A total of 114 neonatal bacterial infection (neonatal sepsis group and general infection group) were divided into shock group (39 cases) and non-shock group (75 cases). The levels of plasma HBP and PTX3 were tested with immunoturbidimetry and ELSIA respectively. The results of procalcitonin (PCT) and white blood cells (WBC) counts were collected. Non-parametric test were performed for non-normal distribution data; the diagnostic performances of data were evaluated by receiver operating characteristic (ROC) curve; pearson correlation coefficient was performed for correlation analysis.Results Plasma levels of HBP in neonatal sepsis group, general infection group and control group were (64.41±78.51) ng/ml, (47.16±50.59) ng/ml and (31.97±20.76) ng/ml, respectively; plasma levels of PTX3 were (2.23±1.44) ng/ml, (1.76±0.94) ng/ml and (1.26±0.66) ng/ml, respectively;serum levels of PCT were (31.92±36.65)ng/ml, (7.72±9.28)ng/ml and(1.87±5.02)ng/ml, respectively. The levels of PTX3 and PCT in neonatal sepsis group were significantly higher than in general infection group (Z=3.74, Z=5.01, all P<0.05) and control group (Z=3.98, Z=5.20, all P<0.05). The levels of HBP in neonatal sepsis group were significantly higher than in control group (Z=2.37, P<0.05), but there were no significant difference in neonatal sepsis group and general infection group (Z=1.16, P>0.05). The levels of PTX3 and PCT in shock group were significantly higher than in non-shock group (Z=2.20, Z=3.70, all P<0.05), but there were no significant difference in plasma HBP of shock and non-shoc

关 键 词：细菌感染 血蛋白质类 载体蛋白质类 抗微生物阳离子肽类 血清淀粉样P成分 C反应蛋白质 婴儿 新生 

分 类 号：R722.13[医药卫生—儿科] R446.6[医药卫生—临床医学]