Division of Neonatology, Health Research Institute La Fe, Valencia, Spain.
Acta Paediatr. 2012 May;101(5):e203-7. doi: 10.1111/j.1651-2227.2011.02577.x. Epub 2012 Jan 10.
To compare diagnostic accuracy in cord blood of interleukin-6 (IL-6) with C-reactive protein (CRP) as predictors of early-onset neonatal sepsis (EOS) in newborns with prenatal risk factors for infection.
During 12 months, cord blood IL-6 and CRP were measured immediately after birth in neonates with prenatal risk factors of infection. The odds of developing sepsis based on IL-6 and CRP values were calculated using likelihood ratios (LR), and their accuracy as predictors was compared by binary logistic regression. Multivariable logistic regression analyses were performed to identify independent risk factors for sepsis.
Ten of 128 neonates (7.8%) were diagnosed with EOS confirmed with positive blood culture in five cases (3.9%). Cord blood IL-6 was a greater predictor of sepsis than CRP [ROC for IL-6 (0.88) vs. CRP (0.70)]. IL-6-positive and IL-6-negative LR [7.14 vs. -0.11] were superior to those calculated for CRP [2.86 vs. -0.51]. Chorioamnionitis and Apgar at 1 min were identified as independent risk factors for EOS.
Cord blood IL-6 showed superior LR than CRP; therefore, it is a better predictor to initiate treatment in neonates with prenatal infectious risk factors immediately after birth.
比较有产前感染危险因素的新生儿脐带血中白细胞介素 6（IL-6）与 C 反应蛋白（CRP）作为早期新生儿败血症（EOS）预测因子的诊断准确性。
在 12 个月内，对有产前感染危险因素的新生儿在出生后立即测量脐带血中的 IL-6 和 CRP。使用似然比（LR）计算基于 IL-6 和 CRP 值发生败血症的可能性，并通过二项逻辑回归比较其作为预测因子的准确性。进行多变量逻辑回归分析以确定败血症的独立危险因素。
在 128 例新生儿中，有 10 例（7.8%）被诊断为 EOS，其中 5 例（3.9%）通过阳性血培养证实。脐带血 IL-6 是败血症的预测因子，优于 CRP [IL-6 的 ROC（0.88）与 CRP（0.70）]。IL-6 阳性和 IL-6 阴性 LR[7.14 与-0.11]优于 CRP 计算的 LR[2.86 与-0.51]。绒毛膜羊膜炎和 1 分钟时的 Apgar 评分被确定为 EOS 的独立危险因素。
脐带血 IL-6 的 LR 优于 CRP；因此，它是一种更好的预测因子，可用于有产前感染危险因素的新生儿在出生后立即开始治疗。
