Ucar Birsen, Yildiz Bilal, Aksit M Arif, Yarar Coskun, Colak Omer, Akbay Yildiz, Colak Ertugrul
Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, 26480 Eskisehir, Turkey.
Mediators Inflamm. 2008;2008:737141. doi: 10.1155/2008/737141. Epub 2008 Nov 16.
Sepsis is an important cause of mortality in newborns. However, a single reliable marker is not available for the diagnosis of neonatal late-onset sepsis (NLS). The aim of this study is to evaluate the value of serum amyloid A (SAA) and procalcitonin (PCT) in the diagnosis and follow-up of NLS.
36 septic and healthy newborns were included in the study. However, SAA, PCT, TNF-alpha, IL-1beta, and CRP were serially measured on days 0, 4, and 8 in the patients and once in the controls. Töllner's sepsis score (TSS) was calculated for each patient.
CRP, PCT, and TNF-alpha levels in septic neonates at each study day were significantly higher than in the controls (P = .001). SAA and IL-1beta levels did not differ from healthy neonates. The sensitivity and specificity were 86.8% and 97.2% for PCT, 83.3% and 80.6% for TNF-alpha, 75% and 44.4% for SAA on day 0.
Present study suggests that CRP seems to be the most helpful indicator and PCT and TNF-alpha may be useful markers for the early diagnosis of NLS. However, SAA, IL-1beta, and TSS are not reliable markers for the diagnosis and follow-up of NLS.
脓毒症是新生儿死亡的重要原因。然而，目前尚无单一可靠的标志物可用于诊断新生儿晚发性脓毒症（NLS）。本研究旨在评估血清淀粉样蛋白A（SAA）和降钙素原（PCT）在NLS诊断及随访中的价值。
本研究纳入了36例脓毒症新生儿及健康新生儿。然而，对患者在第0天、第4天和第8天连续检测SAA、PCT、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）和C反应蛋白（CRP），对照组仅检测一次。为每位患者计算托勒尔脓毒症评分（TSS）。
在每个研究日，脓毒症新生儿的CRP、PCT和TNF-α水平均显著高于对照组（P = 0.001）。SAA和IL-1β水平与健康新生儿无差异。第0天时，PCT的敏感性和特异性分别为86.8%和97.2%，TNF-α为83.3%和80.6%，SAA为75%和44.4%。
本研究表明，CRP似乎是最有用的指标，PCT和TNF-α可能是NLS早期诊断的有用标志物。然而，SAA、IL-1β和TSS不是NLS诊断及随访的可靠标志物。
