早产儿脐血AAG、IL-6、TNF-α水平对早发型败血症的预测价值  

Predictive and prognostic potentials of AAG,IL-6 and TNF-α levels in the umbilical cord blood of preterm infants in the early onset neonatal sepsis

作　　者：姚彦莉[1] YAO Yanli(Qinghai Red Cross Hospital,Qinghai,Xining 810000,China)

机构地区：[1]青海红十字医院,青海省西宁市810000

出　　处：《河北医药》2023年第8期1170-1173,共4页Hebei Medical Journal

基　　金：青海省科技支撑计划项目(编号:090NKCA111)。

摘　　要：目的探讨早产儿脐血α1-酸性糖蛋白(AAG)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平对早发型败血症(EOS)的预测价值及对预后的影响。方法选取2019年1月至2022年1月EOS患儿46例作为发生组,另选取同期46例无EOS早产儿作为未发生组,均于出生后留取脐血样本,比较2组临床资料、脐血AAG、IL-6、TNF-α水平,分析脐血AAG、IL-6、TNF-α水平与EOS发生的关系及预测价值,并对比不同预后患儿脐血AAG、IL-6、TNF-α水平,评价各指标对预后的影响。结果发生组脐血AAG、IL-6、TNF-α水平高于未发生组(P<0.05);Logistic回归分析,校正胎龄、极低出生体质量儿、呼吸功能低下等其他因素前后,脐血AAG、IL-6、TNF-α均与EOS发生独立相关(P<0.05);脐血AAG、IL-6、TNF-α联合预测EOS发生的AUC为0.925(95%CI:0.851~0.970),大于三者单独预测;随访至所有患儿出院,预后良好31例,预后不良15例,预后不良患儿脐血AAG、IL-6、TNF-α水平高于预后良好患儿(P<0.05);危险度分析,脐血AAG、IL-6、TNF-α高水平患儿预后不良风险是低水平患儿的4.574倍(95%CI:1.165~17.967)、4.000倍(95%CI:1.298~12.326)、5.460倍(95%CI:1.386~21.509)。结论早产儿脐血AAG、IL-6、TNF-α水平联合预测EOS的价值较为可靠,且三者异常升高表达均会显著增加预后不良风险,可为临床防治提供相关依据。Objective To investigate the predictive and prognostic potentials of acidic glycoprotein(AAG),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels in the umbilical cord blood of preterm infants in the early-onset sepsis(EOS).Methods Forty-six preterm infants with EOS in our hospital from January 2019 to January 2022 were selected as the occurrence group,and the other 46 infants born prematurely without EOS in the same period were selected as the non-occurrence group.Umbilical cord blood samples were collected after birth.Clinical data,and AAG,IL-6 and TNF-αlevels in the umbilical cord blood were compared between groups.The predictive value of AAG,IL-6 and TNF-αlevels in the umbilical cord blood in EOS was analyzed.The prognosis in preterm infants with EOS expressing varied levels of AAG,IL-6 and TNF-αwas compared.Results AAG,IL-6 and TNF-αlevels in the umbilical cord blood were significantly higher in the occurrence group than those in the non-occurrence group(P<0.05).Logistic regression analysis showed that AAG,IL-6 and TNF-αlevels in the umbilical cord blood were independently correlated with the occurrence of EOS after adjusting gestational age,very low birthweight infants,and respiratory hypoplasia(P<0.05).The area under the curve(AUC)of a combination detection of AAG,IL-6 and TNF-αlevels in the umbilical cord blood in predicting EOS was 0.925(95%CI:0.851-0.970),which was larger than a single detection.Follow-up was performed until all infants were discharged,and there were 31 cases with good prognosis and 15 cases with poor prognosis.AAG,IL-6 and TNF-αlevels in the umbilical cord blood of those with a poor prognosis were significantly higher than infants with a good prognosis(P<0.05).Risk analysis showed that the risk of poor prognosis in preterm infants with EOS and high AAG,IL-6 and TNF-αlevels in the umbilical cord blood was 4.574(95%CI:1.165-17.967),4.000(95%CI:1.298-12.326),and 5.460(95%CI:1.386-21.509)times higher than those with low levels of AAG,IL-6,and TNF-α.Conclusion AAG,IL-6 an

关 键 词：早产儿 早发型败血症 Α1-酸性糖蛋白 白细胞介素-6 肿瘤坏死因子-Α 预测价值 预后 

分 类 号：R722.6[医药卫生—儿科]