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髓系细胞表面可溶性触发受体(sTREM-1)对感染性早产新生儿迟发性败血症的诊断价值

Diagnostic value of urine soluble triggering receptor expressed on myeloid cells (sTREM-1) for late-onset neonatal sepsis in infected preterm neonates.

作者信息

Alkan Ozdemir Senem, Ozer Esra Arun, Ilhan Ozkan, Sutcuoglu Sumer, Tatlı Mansur

机构信息

1 Department of Neonatology, Behcet Uz Children's Hospital, Izmir Turkey.

2 Department of Neonatology, Mugla Sitki Koçman University, Mugla, Turkey.

出版信息

J Int Med Res. 2018 Apr;46(4):1606-1616. doi: 10.1177/0300060517749131. Epub 2018 Feb 26.

Abstract

Objective Sepsis is a complex clinical condition caused by a dysregulated immune response to an infection resulting in a fatal outcome. This study aimed to investigate the value of urine soluble triggering receptor expressed on myeloid cells (sTREM-1) for diagnosing culture-proven sepsis in preterm infants. Methods Preterm neonates were evaluated for late-onset sepsis (LOS). Laboratory investigations were performed. Urine sTREM-1 samples and blood cultures were synchronously collected. Using blood culture results, preterm neonates were divided into the culture-proven group and suspected sepsis group. Results A total of preterm 62 infants were included in the study; 31 had culture-proven sepsis and 31 were suspected as having sepsis. There were no significant differences in gestational age, sex, birth weight, and delivery mode between the groups. Neonates in the culture-proven group had significantly higher urine sTREM-1 levels than did those in the suspected sepsis group. Using a cut-off point for a urine sTREM-1 level of 78.5 pg/mL, the sensitivity was 0.90, specificity was 0.78, positive predictive value was 0.68, and negative predictive value was 0.94. Conclusions The present study highlights the role of urine sTREM-1 levels in LOS. Urine sTREM-1 may be a reliable and sensitive marker in detecting sepsis in preterm infants.

摘要

目的

脓毒症是一种复杂的临床病症,由对感染的免疫反应失调导致致命后果。本研究旨在探讨髓系细胞表面可溶性触发受体(sTREM-1)在诊断早产儿血培养确诊脓毒症中的价值。方法:对早产儿进行晚发型脓毒症(LOS)评估。进行实验室检查。同步采集尿液sTREM-1样本和血培养样本。根据血培养结果,将早产儿分为血培养确诊组和疑似脓毒症组。结果:本研究共纳入62例早产儿;31例血培养确诊脓毒症,31例疑似脓毒症。两组在胎龄、性别、出生体重和分娩方式方面无显著差异。血培养确诊组新生儿尿液sTREM-1水平显著高于疑似脓毒症组。以尿液sTREM-1水平78.5 pg/mL为截断点,敏感性为0.90,特异性为0.78,阳性预测值为0.68,阴性预测值为0.94。结论:本研究突出了尿液sTREM-1水平在LOS中的作用。尿液sTREM-1可能是检测早产儿脓毒症的可靠且敏感的标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02a7/6091820/051350e0beb4/10.1177_0300060517749131-fig1.jpg

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