Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Acta Paediatr. 2012 Mar;101(3):242-6. doi: 10.1111/j.1651-2227.2011.02511.x. Epub 2011 Nov 28.
To evaluate the serum levels of three precursors of vasoactive peptide as diagnostic markers for neonatal infections.
Overall, 356 neonates (160 without infection, 114 with mild infections and 82 with severe infections) were enrolled in this study. Their serum levels of mid-regional pro-adrenomedullin (MR-pro-ADM), C-terminal pro-endothelin-1 (CT-pro-ET-1) and mid-regional pro-atrial natriuretic peptide (MR-pro-ANP) were measured by immunoassay, and receiver operating curve analysis was performed for each biomarker to evaluate their diagnostic values for neonatal infection.
The serum levels of MR-pro-ADM (2.079 ± 1.195 nM), CT-pro-ET-1 (109.4 ± 62.9 pM) and MR-pro-ANP (1221.4 ± 725.0 pM) in the severe infection group were significantly higher than those in the mild infection group (1.025 ± 0.421 nM, 86.7 ± 51.8 pM, and 687.6 ± 575.7 pM, respectively) and in the non-infection group (0.853 ± 0.488 nM, 51.3 ± 40.6 pM, and 943.3 ± 847.3 pM, respectively) (p < 0.01-0.001). Their areas under the curve were 0.72, 0.76 and 0.61, respectively. Among them, CT-pro-ET-1 had the highest sensitivity (82.65%), whereas MR-pro-ADM had the highest specificity (86.25%).
MR-pro-ADM, CT-pro-ET-1 and MR-pro-ANP may serve as useful laboratory markers to indicate bacterial infection in neonates.
评估三种血管活性肽前体作为新生儿感染诊断标志物的血清水平。
共纳入 356 例新生儿（无感染 160 例，轻度感染 114 例，重度感染 82 例）。采用免疫分析法测定其中脑利钠肽前体（MR-pro-ANP）、C 端内皮素-1 前体（CT-pro-ET-1）和中脑利钠肽前体（MR-pro-ADM）的血清水平，并对每种生物标志物进行受试者工作特征曲线分析，评估其对新生儿感染的诊断价值。
重度感染组血清中 MR-pro-ADM（2.079±1.195 nM）、CT-pro-ET-1（109.4±62.9 pM）和 MR-pro-ANP（1221.4±725.0 pM）水平明显高于轻度感染组（1.025±0.421 nM、86.7±51.8 pM 和 687.6±575.7 pM）和无感染组（0.853±0.488 nM、51.3±40.6 pM 和 943.3±847.3 pM）（p＜0.01-0.001）。曲线下面积分别为 0.72、0.76 和 0.61。其中 CT-pro-ET-1 的敏感性最高（82.65%），而 MR-pro-ADM 的特异性最高（86.25%）。
MR-pro-ADM、CT-pro-ET-1 和 MR-pro-ANP 可作为新生儿细菌感染的有用实验室标志物。
