RIP3、nCD11b、PCT动态变化在新生儿败血症中的预测价值  

Predictive value of RIP3,nCD11b and PCT dynamic changes in neonatal sepsis

作　　者：冯小云 蔡亲武 王昌乐 罗海畅 Feng Xiaoyun;Cai Qinwu;Wang Changle;Luo Haichang(Department of Pediatrics,Wanning People's Hospital of Hainan Province,Hainan,Wanning 571500,China;Department of Neonatology,Wanning People's Hospital of Hainan Province,Hainan,Wanning 571500,China)

机构地区：[1]海南省万宁市人民医院儿科,海南万宁571500 [2]海南省万宁市人民医院新生儿科,海南万宁571500

出　　处：《发育医学电子杂志》2024年第5期342-349,共8页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的探究新生儿败血症治疗过程中血清受体相互作用蛋白3(receptor interacting protein 3,RIP3)、分化抗原簇分子11b(antigen cluster differentiation molecule 11b,nCD11b)、降钙素原(procalcitonin,PCT)的动态变化及意义。方法采用前瞻性研究方法,选取2020年9月至2022年10月海南省万宁市人民医院收治的80例新生儿败血症患儿,根据疗效不同将其分为有效组(n=56)和无效组(n=24)。比较两组患儿的基线资料,治疗前、治疗24 h、72 h后RIP3、nCD11b、PCT,白细胞计数(white blood cell count,WBC),C-反应蛋白(C-reactive protein,CRP)水平。统计学方法采用t检验、χ^(2)检验、重复测量方差分析、Spearman法、Logistic回归分析、受试者操作特征(receiver operating characteristic,ROC)曲线分析及临床决策分析(clinical decision analysis,CDA)。结果有效组治疗24、72 h后RIP3低于无效组[24 h:(18.5±5.0)µg/L与(22.8±7.6)µg/L,72 h:(13.6±3.2)µg/L与(21.8±6.9)µg/L,F_(组间)=9.102,P值均<0.05];有效组治疗24、72 h后nCD11b低于无效组[24 h:(2.5±0.8)%与(3.8±1.2)%,72 h:(1.6±0.5)%与(3.7±1.2)%,F_(组间)=8.596,P值均<0.05];有效组治疗24、72 h后PCT低于无效组[24 h:(4.5±1.3)µg/L与(5.2±1.1)µg/L,72 h:(1.3±0.4)µg/L与(5.1±1.2)µg/L,F_(组间)=13.841,P值均<0.001];有效组治疗24、72 h后CRP低于无效组[24 h:(22.2±7.2)mg/L与(25.7±8.1)mg/L,72 h:(20.2±6.7)mg/L与(24.6±6.8)mg/L,F_(组间)=10.869,P值均<0.001]。Logistic回归分析结果显示,治疗72 h后,RIP3、nCD11b、PCT、CRP均是新生儿败血症疗效的独立相关影响因素(OR值分别为4.163、4.469、6.337、3.128,P值均<0.001);Spearman相关性分析结果显示,治疗72 h后,各指标与疗效相关性更强(r值更大),且RIP3、nCD11b、PCT的r值均大于CRP,与疗效相关性更强;ROC曲线分析结果显示,治疗72 h后,RIP3+nCD11b+PCT联合检测的曲线下面积(area under the curve,AUC)最大(0.939),预测灵敏度为87.50%,特异性为87.50%(P<0.001);DCA曲线分析结果Objective To explore the dynamic changes and significance of receptor interacting protein 3(RIP3),antigen cluster differentiation molecule 11b(nCD11b),and procalcitonin(PCT)in the treatment of neonatal sepsis.Method A prospective study was conducted on 80 neonates with sepsis admitted to Wanning People's Hospital of Hainan Province from September 2020 to October 2022,they were divided into effective group(n=56)and ineffective group(n=24)according to the different efficacy.The baseline data,the levels of RIP3,nCD11b,PCT,white blood cell count(WBC),and C-reactive protein(CRP)at pre-treatment,24-hour post-treatment,and 72-hour post-treatment were compared between the two groups.The statistical methods performed by t-test,χ^(2) test,repeated measure ANOVA,Spearman method,Logistic regression analysis,receiver operating characteristic(ROC)curve analysis and clinical decision analysis(CDA).Result RIP3 in the effective group was lower than that in the ineffective group after 24 h and 72 h treatment[24 h:(18.5±5.0)μg/L vs(22.8±7.6)μg/L,72 h:(13.6±3.2)μg/L vs(21.8±6.9)μg/L,F_(between groups)=9.102,all P<0.05].nCD11b in the effective group was lower than that in the ineffective group after 24 h and 72 h treatment[24 h:(2.5±0.8)%vs(3.8±1.2)%,72 h:(1.6±0.5)%vs(3.7±1.2)%,F_(between groups)=8.596,all P<0.05].The PCT in the effective group was lower than that in the ineffective group after 24 h and 72 h treatment[24 h:(4.5±1.3)μg/L vs(5.2±1.1)μg/L,72 h:(1.3±0.4)μg/L vs(5.1±1.2)μg/L,F=13.841,all P<0.001].The CRP in the effective group was lower than that in the ineffective group after 24 h and 72 h treatment[24 h:(22.2±7.2)mg/L vs(25.7±8.1)mg/L,72 h:(20.2±6.7)mg/L vs(24.6±6.8)mg/L,F_(between groups)=10.869,all P<0.001].Logistic regression analysis showed that RIP3,nCD11b,PCT,and CRP were all independent factors related to the efficacy of neonatal sepsis after 72 h treatment(OR values were 4.163,4.469,6.337,and 3.128,respectively,all P<0.001).Spearman correlation analysis showed that the indicators were mo

关 键 词：新生儿 败血症 受体相互作用蛋白3 分化抗原簇分子11b 降钙素原 疗效 

分 类 号：R722.131[医药卫生—儿科]