Omran Ahmed, Ali Mohammed, Saleh Mai H, Zekry Osama
Departments of Pediatrics & Neonatology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Clin Respir J. 2018 Apr;12(4):1644-1650. doi: 10.1111/crj.12723. Epub 2017 Nov 16.
Neonatal pneumonia is an important and major cause of neonatal morbidity and mortality worldwide therefore; its early detection plays a crucial role in successful therapy. Analysis of saliva as a non-invasive method for detection of neonatal diseases holds great promise for improving health care. Till now, salivary C-reactive protein (CRP), mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR) and platelets/lymphocytes ratio (PLR) have not been studied as markers of diagnosis in neonatal pneumonia.
To assess the applicability of salivary CRP, MPV, NLR and PLR as diagnostic markers in late-onset neonatal pneumonia.
A prospective case control study of 70 full-term neonates, 35 with late-onset neonatal pneumonia and 35 healthy controls, was enrolled. Serum and salivary CRP concentrations were measured by ELISA, while MPV, NLR and PLR were measured by automated blood cell counter.
This study showed a statistically significant difference between salivary CRP means in neonates with late-onset neonatal pneumonia vs control neonates (6.2 ± 4.6 and 2.8 ± 1.9 ng/L) respectively. At the cutoff point of 3.8 ng/L, salivary CRP showed 91.4% sensitivity and 80.9% specificity. Salivary CRP also showed accuracy in predicting elevated serum CRP in neonates with pneumonia. MPV showed a significant difference between pneumonia and controls (mean = 10.2 ± 0.7, 8 ± 0.5) respectively. At cutoff point 9.0, it has 80% sensitivity and specificity.
The present study showed for the first time that both salivary CRP and MPV are suitable as diagnostic markers in late-onset neonatal pneumonia.
新生儿肺炎是全球新生儿发病和死亡的重要主要原因，因此其早期检测对成功治疗起着关键作用。唾液分析作为一种检测新生儿疾病的非侵入性方法，在改善医疗保健方面具有巨大潜力。到目前为止，唾液C反应蛋白（CRP）、平均血小板体积（MPV）、中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）尚未作为新生儿肺炎的诊断标志物进行研究。
评估唾液CRP、MPV、NLR和PLR作为晚发性新生儿肺炎诊断标志物的适用性。
纳入70例足月新生儿的前瞻性病例对照研究，其中35例为晚发性新生儿肺炎患儿，35例为健康对照。采用酶联免疫吸附测定法（ELISA）检测血清和唾液CRP浓度，采用自动血细胞计数器检测MPV、NLR和PLR。
本研究显示，晚发性新生儿肺炎患儿与对照新生儿的唾液CRP均值之间存在统计学显著差异（分别为6.2±4.6和2.8±1.9 ng/L）。在3.8 ng/L的临界值时，唾液CRP的敏感性为91.4%，特异性为80.9%。唾液CRP在预测肺炎新生儿血清CRP升高方面也显示出准确性。MPV在肺炎组和对照组之间也存在显著差异（均值分别为10.2±0.7、8±0.5）。在临界值9.0时，其敏感性和特异性均为80%。
本研究首次表明，唾液CRP和MPV均适用于晚发性新生儿肺炎的诊断标志物。
