新生儿肺炎病原菌及血清MCP-1、LPS和IL-6联合检测  

Research on the distribution of pathogenic bacteria and joint detection of serum MCP-1, LPS and IL-6 levels in neonates with infectious pneumonia

作　　者：马岩 金华 张洁 高丽 庄箭波 顾岚 MA Yan;JIN Hua;ZHANG Jie;GAO Li;ZHUANG Jian-bo;GU Lan(Ninth People's Hospital of Suzhou,Suzhou,Jiangsu 215200,China)

机构地区：[1]苏州市第九人民医院新生儿科,江苏苏州215200

出　　处：《中华医院感染学杂志》2020年第16期2532-2535,共4页Chinese Journal of Nosocomiology

基　　金：江苏省科研基金资助项目(20109099)。

摘　　要：目的探究新生儿肺炎的病原菌分布及血清单核细胞趋化因子蛋白1(Monocyte chemoattractant protein-1,MCP-1),脂多糖(Lipopolysaccharide,LPS),白细胞介素-6(Interleukin-6,IL-6)联合检测在新生儿肺炎诊断中的应用价值。方法选取2017年1月-2019年1月苏州市第九人民医院收治的240例新生儿,根据有无发生感染将其分为非感染组146例和感染组94例,检测两组血清MCP-1、LPS、IL-6水平,检测感染组患儿病原菌类型;采用受试者工作特征曲线(Receiver operator characteristic curve,ROC)分析血清MCP-1、LPS、IL-6水平对其临床诊断价值;采用单因素和非条件Logistic回归法分析新生儿肺炎的危险因素。结果感染组标本共分离病原菌67株,其中革兰阴性菌占62.69%,革兰阳性菌占34.33%,真菌占2.99%。治疗前,感染组血清MCP-1、LPS、IL-6表达水平高于非感染组(P<0.05),治疗后,感染组的血清MCP-1、LPS、IL-6表达水平下降,但高于非感染组(P<0.05)。MCP-1、LPS、IL-6三者联合检测新生儿感染性肺炎的诊断效能最高。出生体质量低、血清白蛋白水平低、胎膜早破、宫内窘迫、羊水污染是发生新生儿肺炎的独立危险因素(P<0.05)。结论新生儿感染性肺炎患儿的病原菌主要为革兰阴性菌,血清MCP-1、LPS、IL-6在新生儿感染性肺炎的诊断中具有重要价值。OBJECTIVE To explore the distribution of pathogenic bacteria in neonatal infectious pneumonia and the application value of combined detection of monocyte chemoattractant protein-1(MCP-1), lipopolysaccharide(LPS) and interleukin-6(IL-6) in the diagnosis of neonatal infectious pneumonia. METHODS Total of 240 newborns born in the Ninth People’s Hospital of Suzhou from Jan. 2017 to Jan. 2019 were divided into the non-infection group(146 cases) and the infection group(94 cases). The levels of serum MCP-1, LPS and IL-6 and the types of pathogenic bacteria in the experimental group were detected. The receiver operator characteristic(ROC) curve was used to analyze the clinical value of serum MCP-1, LPS and IL-6 levels for the evaluation of the disease, and the risk factors of neonatal infectious pneumonia were analyzed by univariate and unconditional logistic regression. RESULTS A total of 67 pathogenic bacteria strains were isolated from the infection group, most of which were Gram-negative bacteria(62.69%) accounted for the most, followed with Gram-positive bacteria(34.33%) and fungi(2.99%). Before the treatment, levels of MCP-1, LPS and IL-6 in the infection group were higher than that in the non-infection group. After the treatment, the levels of MCP-1, LPS and IL-6 in the infection group decreased significantly(P<0.05), but was higher than that in the non-infection group. The combination detection of MCP-1, LPS and IL-6 were the most effective diagnostic method for the neonatal infectious pneumonia. Low birth weight, low serum protein level, premature rupture of membranes, intrauterine distress, amniotic fluid pollution were the independent risk factors for neonatal infectious pneumonia. CONCLUSION Gram negative bacteria were the main pathogens in neonatal infectious pneumonia. Serum MCP-1, LPS and IL-6 levels may have important value in the diagnosis of neonatal infectious pneumonia.

关 键 词：新生儿 肺炎 病原菌 诊断价值 

分 类 号：R722.135[医药卫生—儿科]