脐带血sTREM-1、SuPAR、pro-ADM检测诊断未足月胎膜早破新生儿细菌感染的价值  

Value of umbilical cord blood sTREM-1,SuPAR and pro-ADM in diagnosis of bacterial infection in neonates with premature rupture of membranes

作　　者：牟娜 李凤 安超 安莉莉 邹潇璐 MU Na;LI Feng;AN Chao;AN Li-li;ZOU Xiao-lu(Rizhao Maternal and Child Health Hospital,Rizhao,Shandong 276800,China)

机构地区：[1]日照市妇幼保健院院感科,山东日照276800 [2]日照市妇幼保健院产科,山东日照276800 [3]日照市妇幼保健院儿科,山东日照276800 [4]日照市妇幼保健院新生儿科,山东日照276800

出　　处：《中华医院感染学杂志》2020年第18期2821-2824,共4页Chinese Journal of Nosocomiology

基　　金：山东省科研基金资助项目(2017SH103)。

摘　　要：目的探究脐带血肾上腺髓质素前体(Proadreno medullin,Pro-ADM)、可溶性髓样细胞触发受体(soluble triggering receptors expressedon myeloid cells,sTREM)、可溶性尿激酶型纤溶酶原激活物受体(soluble urokinase-type plasminogen activator receptor,SuPAR)水平对未足月胎膜早破新生儿细菌感染的诊断价值。方法选择日照市妇幼保健院2016年9月-2019年9月未足月胎膜早破感染新生儿60例作为感染组,另选取同期未足月胎膜早破新生儿64例作为非感染组。采集新生儿咽、耳拭子或全血标本进行细菌培养,采用ELISA法对脐带血sTREM-1、SuPAR、pro-ADM水平进行检测。结果感染组新生儿所有临床标本共培养出病原菌63株,以革兰阴性菌为主,41株占65.08%;感染组新生儿脐带血sTREM-1、SuPAR、pro-ADM水平分别为(63.52±25.52)pg/ml、(18.25±5.62)pg/ml、(53.72±14.29)pg/ml显著高于非感染组,差异具有统计学意义(t=9.146、12.173、9.235,P均<0.001);脐带血sTREM-1、SuPAR、pro-ADM水平对未足月胎膜早破新生儿细菌感染均具有良好的预测价值,曲线下面积(AUC)均大于0.75。结论未足月胎膜早破新生儿细菌感染以革兰阴性菌感染为主,脐带血sTREM-1、SuPAR、pro-ADM水平具有良好的诊断价值。OBJECTIVE To explore the value of proadreno medullin(Pro-ADM),soluble triggering receptors expressed on myeloid cells(sTREM)and soluble urokinase-type plasminogen activator receptor(SuPAR)in diagnosis of bacterial infection in the neonates with premature rupture of membranes(PROM).METHODS Totally 60 PROM neonates with infection who were treated in Rizhao Maternal and Child Health Hospital from Sep 2016 to Sep 2019 were assigned as the infection group,meanwhile,64 PROM neonates were chosen as the non-infection group.The throat swabs,ear swabs or whole blood specimens were collected for bacterial culture,and the levels of umbilical cord blood sTREM-1,SuPAR and pro-ADM were detected by means of ELISA.RESULTS A total of 63 strains of pathogens were isolated from all of the clinical specimens of the neonates in the infection group,41(65.08%)of which were gram-negative bacteria.The levels of umbilical cord blood sTREM-1,SuPAR and pro-ADM of the infection group were respectively(63.52±25.52)pg/ml,(18.25±5.62)pg/ml and(53.72±14.29)pg/ml,significantly higher than those of the non-infection group(t=9.146,12.173,9.235,all P<0.001).The umbilical cord blood sTREM-1,SuPAR and pro-ADM had high value in prediction of bacterial infection in the PROM neonates,and the area under curve(AUC)was more than 0.75.CONCLUSION The neonates with gram-negative bacteria infection are dominant among the PROM neonates with bacterial infection.The umbilical cord blood sTREM-1,SuPAR and pro-ADM have high predictive value.

关 键 词：肾上腺髓质素前体 可溶性髓样细胞触发受体 可溶性尿激酶型纤溶酶原激活物受体 胎膜早破 新生儿 细菌感染 

分 类 号：R722.13[医药卫生—儿科]