Arnon Shmuel, Litmanovitz Ita, Regev Rivka, Bauer Sofia, Lis Monica, Shainkin-Kestenbaum Ruth, Dolfin Tzipora
Department of Neonatology, Meir Hospital, Sapir Medical Center, 59 Tchernichovsky Street, IL-44281 Kfar-Saba, Israel.
Biol Neonate. 2005;87(2):105-10. doi: 10.1159/000081979. Epub 2004 Nov 9.
Few studies demonstrated that serum amyloid A (SAA), a non-specific acute-phase reactant, could be used as a reliable early marker for the diagnosis of late-onset sepsis (LOS).
To evaluate the diagnostic value and the dynamics of SAA levels during the course of LOS and to compare it to those of other inflammatory markers.
Levels of SAA, C-reactive protein (CRP) and IL-6 together with clinical variables, biochemical parameters and cultures retrieved from all preterm infants suspected of LOS were checked at the first suspicion of sepsis and after 8, 24, 48 and 72 h. Results were compared to healthy, matched infants.
One hundred and sixteen infants were included in the study, 38 in the sepsis and 78 in the non-sepsis group. High levels of SAA were observed at sepsis onset, with a gradual decline thereafter, while CRP levels increased only at 24 h after sepsis onset. In the sepsis group, levels of SAA returned faster to baseline than CRP levels. Receiver-operating characteristic analysis values revealed that SAA at 10 mug/ml had the highest sensitivity at 0, 8 and 24 h after sepsis onset (95, 100 and 97%, respectively) and a negative predictive value (97, 100 and 98%, respectively).
SAA is an accurate acute-phase protein during LOS in preterm infants. Quick and reliable SAA kits can make this marker a useful tool in LOS in preterm infants.
少数研究表明，血清淀粉样蛋白A（SAA）作为一种非特异性急性期反应物，可作为晚发性败血症（LOS）诊断的可靠早期标志物。
评估SAA水平在LOS病程中的诊断价值及动态变化，并与其他炎症标志物进行比较。
对所有疑似LOS的早产儿，在首次怀疑败血症时以及之后的8、24、48和72小时，检测SAA、C反应蛋白（CRP）和白细胞介素-6水平，同时检查临床变量、生化参数及培养结果。将结果与健康匹配婴儿进行比较。
116名婴儿纳入研究，其中败血症组38名，非败血症组78名。败血症发作时观察到SAA水平升高，此后逐渐下降，而CRP水平仅在败血症发作后24小时升高。在败血症组中，SAA水平比CRP水平更快恢复到基线。受试者工作特征分析值显示，败血症发作后0、8和24小时，SAA浓度为10μg/ml时具有最高敏感性（分别为95%、100%和97%）及阴性预测值（分别为97%、100%和98%）。
SAA是早产儿LOS期间一种准确的急性期蛋白。快速可靠的SAA检测试剂盒可使该标志物成为早产儿LOS诊断的有用工具。
