血清粒细胞巨噬细胞集落刺激因子、人中性粒细胞多肽1-3、CD64联合预测新生儿败血症抗感染转归的价值  

The value of serum GM-CSF,HNP1-3 and CD64 combined to predict anti-infective regression in neonatal sepsis

作　　者：胡婷 刘悦 HU Ting;LIU Yue(Department of Pediatrics,3201 Hospital,Hanzhong,Shaanxi 723000,China;Department of Thoracic Surgery,Tangdu Hospital,Second Affiliated Hospital of Air Force Military Medical University,Xi'an,Shaanxi 710000,China)

机构地区：[1]三二〇一医院儿科,陕西汉中723000 [2]空军军医大学第二附属医院唐都医院胸外科,陕西西安710000

出　　处：《安徽医药》2023年第9期1791-1795,I0001,共6页Anhui Medical and Pharmaceutical Journal

基　　金：陕西省医学科学研究课题计划项目(2017JM2819)。

摘　　要：目的探讨血清粒细胞巨噬细胞集落刺激因子(GM-CSF)、人中性粒细胞多肽1-3(HNP1-3)、中性粒细胞表面抗原CD64联合预测新生儿败血症抗感染转归结局及预防措施。方法选取三二〇一医院2019年1月至2021年10月新生儿败血症病儿92例作为研究对象,均行抗感染治疗,治疗7 d后根据抗感染转归结局分为有效组(69例)与无效组(23例)。比较两组血清GM-CSF、HNP1-3、CD64水平,分析各血清指标预测抗感染转归结局的预测价值。结果无效组血清GM-CSF(0.24±0.08)µg/L、HNP1-3(92.75±17.22)µg/L、CD64(1281.00±89.04)平均荧光强度(MFI)高于有效组(0.17±0.05)µg/L、(78.40±14.16)µg/L、(362.00±82.37)MFI(P<0.05);血清GM-CSF、HNP1-3、CD64水平与新生儿败血症病情程度呈正相关(P<0.05);logistic回归分析,校正前,病情程度、低体质量儿、早产、合并化脓性脑膜炎、血清GM-CSF、HNP1-3、CD64对新生儿败血症抗感染转归结局有独立影响,校正病情程度、低体质量儿、早产、合并化脓性脑膜炎等其他因素后,血清GM-CSF、HNP1-3、CD64仍对新生儿败血症抗感染转归结局有独立影响(P<0.05);血清GM-CSF、HNP1-3、CD64联合预测新生儿抗感染转归结局的AUC为0.91[95%CI:(0.83,0.96)],大于各指标单独预测0.84[95%CI:(0.75,0.91)]、0.80[95%CI:(0.70,0.87)]、0.77[95%CI:(0.67,0.85)],灵敏度为91.30%,特异度为81.16%。结论血清GM-CSF、HNP1-3、CD64联合预测新生儿败血症抗感染转归结局的价值较为可靠,临床可根据其血清水平变化制定相关防治措施,同时还应关注病情程度、低体质量儿、早产、合并化脓性脑膜炎等因素对抗感染转归结局的影响。Objective To investigate the combination of serum granulocyte-macrophage colony-stimulating factor(GM-CSF),human neutrophil polypeptide 1-3(HNP1-3)and neutrophil surface antigen CD64 in predicting the outcome of anti-infective regression and preventive measures in neonatal sepsis.Methods A total of 92 children with neonatal sepsis in the 3201 Hospital from January 2019 to October 2021 were selected as the research subjects,and all of them were treated with anti-infective therapy and were divided into an effective group(69 cases)and an ineffective group(23 cases)according to the outcome of anti-infection regression after 7 d of treatment.The serum levels of GM-CSF,HNP1-3 and CD64 were compared between the two groups,and the predictive value of each serum index in predicting the outcome of anti-infection regression was analyzed.Results The mean fluorescence intensity(MFI)of serum GM-CSF,HNP1-3 and CD64 in the ineffective group were(0.24±0.08)µg/L,(92.75±17.22)µg/L,and(1281.00±89.04)MFI,respectively,which were higher than those in the effective group[(0.17±0.05)µg/L,(78.40±14.16)µg/L,(362.00±82.37)MFI](P<0.05);serum GM-CSF,HNP1-3 and CD64 levels were positively correlated with the degree of neonatal sepsis condition(P<0.05);and logistic regression analysis of precorrection degree of illness,low body mass children,preterm birth,combined purulent meningitis,serum GMCSF,HNP1-3,CD64 had independent effects on the outcome of neonatal sepsis anti-infection regression,after correcting for other factors such as degree of illness,low body mass children,preterm birth,combined purulent meningitis,serum GM-CSF,HNP1-3,CD64 still had an independent effect on the outcome of neonatal sepsis anti-infection regression(P<0.05);the AUC of serum GM-CSF,HNP1-3,and CD64 combined to predict the outcome of neonatal anti-infective regression was 0.91[95%CI:(0.83,0.96)],which was greater than the individual prediction of each metric alone of 0.84[95%CI:(0.75,0.91)],0.80[95%CI:(0.70,0.87)],and 0.77[95%CI:(0.67,0.85)],with a sensitivi

关 键 词：新生儿脓毒症 抗感染 粒细胞巨噬细胞集落刺激因子 人中性粒细胞多肽1-3 CD64 预测价值 

分 类 号：R722.13[医药卫生—儿科]