新生儿B族链球菌早发型败血症临床特点  

Clinical characteristics of early-onset sepsis of neonatal group B Streptococcus

作　　者：符玉水 钟丽花 符元证 高婉迎 杨辉 陈阿阮 霍开明[4] FU Yu-shui;ZHONG Li-hua;FU Yuan-zheng;GAO Wan-ying;YANG Hui;CHEN A-ruan;HUO Kai-ming(Hainan Women and Children Medical Center,Haikou,Hainan 570206,China;不详)

机构地区：[1]海南省妇女儿童医学中心新生儿科,海南海口570206 [2]中国医科大学公共卫生学院卫生毒理学教研室,辽宁沈阳110122 [3]中国疾病预防控制中心传染病预防控制所,北京102206 [4]海南医学院第二附属医院儿科,海南海口570311

出　　处：《中华医院感染学杂志》2021年第12期1781-1785,共5页Chinese Journal of Nosocomiology

基　　金：海南省卫生计生行业科研基金资助项目(15A200096)。

摘　　要：目的探讨新生儿B族链球菌早发型败血症临床特点及其与白细胞介素-6(IL-6)、降钙素原(PCT)、中性粒细胞的关系。方法选取2018年4月-2020年2月海南省妇女儿童医学中心新生儿科收治的50例新生儿血培养B族链球菌(阳性)早发型败血症患儿为研究组,同期选取医院收治的50例新生儿血培养B族链球菌(阴性)早发型败血症患儿为对照组。收集两组患儿的临床资料,比较两组患儿的临床特点以及血清IL-6、PCT、中性粒细胞水平,绘制受试者工作特征曲线评估IL-6、PCT、中性粒细胞在新生儿B族链球菌早发型败血症的诊断价值。结果研究组患儿的喂养不耐受、神经系统并发症、新生儿惊厥以及病理性黄疸的发生率分别为34.00%、22.00%、26.00%、64.00%,均高于对照组(P均<0.05);B族链球菌对四环素、克林霉素具有较高耐药性,对万古霉素、青霉素有较高敏感性;研究组患儿的血清中性粒细胞百分比、IL-6、PCT分别为(67.59±27.23)%、(37.07±10.12)pg/ml、(5.23±2.39)ng/ml,均高于对照组(P均<0.001);受试者工作特征曲线结果显示,IL-6、PCT、中性粒细胞的最佳诊断界值分别为31.02 pg/ml、4.76 ng/ml、60.08%。结论新生儿B族链球菌早发型败血症主要以神经系统损害为临床特征。血清IL-6、PCT以及中性粒细胞百分比均可作为诊断新生儿B族链球菌早发型败血症的早期敏感指标,在实际工作中建议以联合诊断的方式使用。OBJECTIVE To explore the clinical characteristics of early-onset sepsis of neonatal group B Streptococcus and its relationship with interleukin-6(IL-6),procalcitonin(PCT),and neutrophils.METHODS From Apr.2018 to Feb.2020,50 cases of early-onset sepsis newborns with neonatal blood culture group B Streptococcus(positive)admitted to the department of Neonatology,Hainan Women’s and Children’s Medical Center were selected as the research group,and 50 cases of early-onset sepsis newborns with neonatal blood culture group B Streptococcus(negative)admitted to the hospital during the same period were selected as the control group.The clinical data of the two groups of children were collected,the clinical characteristics of the two groups of children and the levels of serum IL-6,PCT,and neutrophils were compared,a receiver operating characteristic curve was drawn to evaluate diagnostic value of IL-6,PCT,and neutrophils in the early-onset sepsis of neonatal group B Streptococcus.RESULTS The incidences of feeding intolerance,neurological complications,neonatal seizures,and pathological jaundice in the study group were 34.00%,22.00%,26.00%,and 64.00%,respectively,all significantly higher than those in the control group(all P<0.05).Group B Streptococci had high drug resistance to tetracycline and clindamycin,and high sensitivity to vancomycin and penicillin.The levels of serum neutrophil percentages IL-6 and PCT,in the study group were(67.59±27.23)%,(37.07±10.12)pg/ml,and(5.23±2.39)ng/ml,respectively,significantly higher than those of the control group(all P<0.001).The receiver operating characteristic curve results showed that the best diagnostic cut-off value of IL-6,PCT,and neutrophils were 31.02 pg/ml,4.76 ng/ml and 60.08%,respectively.CONCLUSION The early-onset sepsis of neonatal group B Streptococcus was mainly characterized by neurological damage.Serum IL-6,PCT levels and the percentage of neutrophils could be used as early sensitive indicators for the diagnosis of early-onset sepsis of neonatal group B Streptoco

关 键 词：新生儿败血症 B族链球菌 早发型 临床特征 白细胞介素-6 降钙素原 中性粒细胞 诊断价值 

分 类 号：R515.3[医药卫生—内科学]