Department of Pediatrics, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Immunology Research Center, Avicenna Research Institute. Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Basic Med Sci. 2013 Dec;16(12):1232-7.
Bacterial infection contributes substantially to neonatal morbidity and mortality. Early diagnosis of neonatal sepsis is difficult because clinical signs are non-specific. We have evaluated serum IL-6, 8 and 10 as potential early diagnostic markers of neonatal infection and their relationship to mortality rate and poor prognosis. Materials and Methods : A total of 84 infants, aged ≥ 72 hr were enrolled in this prospective case-control trial. The case group (n=41) included babies with clinical and laboratory findings compatible with sepsis and/or positive blood or cerebrospinal fluid cultures. The control group (n=43) included healthy infants. IL-6, 8 and 10 were measured for all infants. Receiver-operating characteristic (ROC) curves were used for the determination of thresholds. Results : Statistically significant differences were observed between control and case groups for serum median level of IL-6, 8 and 10 (P<0.001). IL-6 cut-off values of 10.85 Pg/ml for discriminating between cases and controls and 78.2 Pg/ml for predicting mortality are suggested. IL-8 at a cut-off value of 60.05 Pg/ml was valuable for differentiation of definite versus indefinite infection. Conclusion : Evaluating the IL-6, 8 and 10 simultaneously, could improve the sensitivity and specificity of early diagnosis of the neonatal sepsis. Regarding our results, interleukin 6 had the greatest value for predicting infection and possible mortality, whereas IL-8 was valuable for diagnosing definitive infection.
细菌感染是导致新生儿发病率和死亡率的主要原因。由于新生儿败血症的临床症状不具有特异性,因此早期诊断较为困难。我们评估了血清白细胞介素 6、8 和 10 作为新生儿感染的潜在早期诊断标志物及其与死亡率和预后不良的关系。
本前瞻性病例对照研究共纳入 84 名年龄≥72 小时的婴儿。病例组(n=41)包括具有与败血症一致的临床和实验室表现以及血或脑脊液培养阳性的婴儿。对照组(n=43)包括健康婴儿。所有婴儿均检测了白细胞介素 6、8 和 10。使用受试者工作特征(ROC)曲线确定截断值。
对照组和病例组血清白细胞介素 6、8 和 10 的中位数水平存在统计学差异(P<0.001)。建议将白细胞介素 6 的截断值为 10.85Pg/ml 用于区分病例和对照组,截断值为 78.2Pg/ml 用于预测死亡率。白细胞介素 8 的截断值为 60.05Pg/ml 时可用于区分明确感染与不确定感染。
同时评估白细胞介素 6、8 和 10 可以提高新生儿败血症早期诊断的敏感性和特异性。根据我们的结果,白细胞介素 6 对预测感染和可能的死亡率最有价值,而白细胞介素 8 对诊断明确感染有价值。