侵袭性真菌感染新生儿外周血CXCL13基因表达及意义  

Expression of CXCL13 gene in peripheral blood of neonates with invasive fungal infection and its clinical significance

作　　者：李静 张会杰 张素梅 张岚 LI Jing;ZHANG Hui-jie;ZHANG Su-mei;ZHANG Lan(Luoyang Vocational and Technical College,Luoyang,Henan 471000,China;不详)

机构地区：[1]洛阳职业技术学院护理系,河南洛阳471000 [2]河南科技大学第一附属医院呼吸科,河南洛阳 [3]河南科技大学第一附属医院肿瘤科,河南洛阳471000 [4]河南科技大学第一附属医院新生儿重症室,河南洛阳471000

出　　处：《中华医院感染学杂志》2023年第5期781-785,共5页Chinese Journal of Nosocomiology

基　　金：河南省自然科学基金资助项目(201963874)。

摘　　要：目的探讨侵袭性真菌感染(IFI)新生儿外周血趋化因子CXC配体13(CXCL13)基因表达及其临床意义。方法选取2018年9月-2020年10月河南科技大学第一附属医院重症监护病房收治的IFI新生儿46例为研究组和无感染新生儿95例为对照组,观察IFI新生儿真菌感染分布情况,采用实时荧光定量聚合酶链反应(PCR)检测两组新生儿外周血单个核细胞CXCL13 mRNA水平,分析CXCL13 mRNA水平对IFI新生儿预测价值。结果IFI新生儿分离鉴定真菌52株,其中白假丝酵母30株,光滑假丝酵母9株,近平滑假丝酵母8株,热带假丝酵母3株,其他假丝酵母2株;研究组患儿胎龄(<37周)、疾病严重程度(≤90分)构成比例高于对照组(P<0.05),而出生体质量、住院时间(≤8 d)低于对照组(P<0.05);研究组血小板、抗凝血酶Ⅲ(AT-Ⅲ)水平低于对照组(P<0.05),D-二聚体(D-D)、C-反应蛋白(CRP)、降钙素原(PCT)、白细胞(WBC)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-4、IL-6水平和CXCL13 mRNA水平均高于对照组(P<0.05);外周血CXCL13 mRNA水平对IFI新生儿的受试者工作特征(ROC)曲线下面积(AUC)为0.879,敏感度93.53%,特异性66.34%。结论IFI新生儿真菌感染以白假丝酵母感染为主,IFI可提高新生儿外周血CXCL13表达和相关促炎因子水平,CXCL13鉴别IFI新生儿效能较好。OBJECTIVE To explore the expression of chemokine CXC ligand 13(CXCL13)gene in peripheral blood of neonates with invasive fungal infection(IFI)and analyze its clinical significance.METHODS A total of 46 neonates with IFI who were treated in intensive care unit(ICU)of the First Affiliated Hospital of Henan University of Science and Technology from Sep 2018 to Oct 2020 were assigned as the study group,and 95 neonates who did not have infection were chosen as the control group.The distribution of the fungi isolated from the neonates with IFI was observed,the expression level of CXCL13 in peripheral blood mononuclear cells was detected by means of real-time fluorescence polymerase chain reaction(PCR),and the value of CXCL13 in prediction of IFI in neonates was analyzed.RESULTS Totally 52 strains of fungi were isolated from the neonates with IFI,30 of which were Candida albicans,9 were Candida glabrata,8 were Candida parapsilosis,3 were Candida tropicalis,and 2 were other species of Candida.The proportions of the neonates with gestational age less than 37 weeks and severity of disease no more than 90 points were higher in the study group than in the control group(P<0.05),the birth body weight and the proportion of the neonates with length of hospital stay were lower in the study group than in the control group(P<0.05).The levels of platelet and antithrombinⅢ(AT-Ⅲ)of the study group were lower than those of the control group(P<0.05);the levels of D-dimer(D-D),C-reactive protein(CRP),procalcitonin(PCT),white blood cell(WBC),tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interleukin-6(IL-6)and CXCL13 mRNA of the study group were higher than those of the control group(P<0.05).The area under receiver operating characteristic(ROC)curve(AUC)of the peripheral blood CXCL13 mRNA was 0.879 in diagnosis of IFI in neonates,with the sensitivity 93.53%,the specificity 66.34%.CONCLUSION The neonates with C.albicans infection are dominant among the neonates with IFI.The neonates with IFI show the rise of expression levels of

关 键 词：新生儿 新生儿重症监护病房 侵袭性真菌感染 真菌分布 趋化因子CXC配体13 预测价值 临床意义 

分 类 号：R722.13[医药卫生—儿科]