Department of Pediatrics, Celal Bayar University, School of Medicine, Manisa, Turkey.
Indian Pediatr. 2007 Aug;44(8):581-4.
We determined whether initial antithrombin (AT) levels help in diagnosis and prognosis of neonatal sepsis.
Sepsis was diagnosed according to clinical and laboratory findings and positive culture results in 34 of the 54 newborns who presented to the hospital with suspected sepsis. Between AT levels and hematological parameters (fibrinogen levels, prothrombin time (PT), activated partial thromboplastin time (aPTT) and liver function tests), these were correlated each other and with outcome of the babies.
Initial AT and fibrinogen levels were significantly lower in newborns with sepsis compared to control (P < 0.05). Initial AT levels were lower in the ones who developed disseminated intravascular coagulation (DIC) compared to those without DIC (P < 0.05). Initial AT levels were significantly lower in newborns who died as compared to survivors (P < 0.05). Sensitivity of AT was highest at 15 mg/dL for prognosis in neonatal sepsis (sensitivity:92.3%, specificity:61.9%, positive predictive value : 61.9 %; negative predictive value: 61.9%;).
Lower initial AT levels in neonatal sepsis are associated with a severe disease and increased mortality. It may be useful in predicting clinical outcome in neonatal sepsis.
我们旨在确定初始抗凝血酶（AT）水平是否有助于新生儿败血症的诊断和预后。
根据临床和实验室发现以及 54 名疑似败血症入院新生儿的阳性培养结果，诊断败血症。我们将 AT 水平与血液学参数（纤维蛋白原水平、凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）和肝功能检查）进行相关分析，并将其与婴儿的结局相关联。
与对照组相比，败血症新生儿的初始 AT 和纤维蛋白原水平显著降低（P<0.05）。与无弥散性血管内凝血（DIC）的患儿相比，发生 DIC 的患儿初始 AT 水平更低（P<0.05）。与存活患儿相比，死亡患儿的初始 AT 水平显著降低（P<0.05）。AT 的 15mg/dL 预测新生儿败血症预后的灵敏度最高（灵敏度：92.3%，特异性：61.9%，阳性预测值：61.9%；阴性预测值：61.9%）。
新生儿败血症中初始 AT 水平较低与严重疾病和死亡率增加有关。它可能有助于预测新生儿败血症的临床结局。
