Fahmey Sameh Samir, Mostafa Heba, Elhafeez Noha Abd, Hussain Heba
Pediatrics Department, Beni-Suef University, Beni Suef, Egypt.
Clinical and Chemical Pathology Department, Beni-Suef University, Beni Suef, Egypt.
Korean J Pediatr. 2018 May;61(5):156-159. doi: 10.3345/kjp.2018.61.5.156. Epub 2018 May 28.
Sepsis is a major cause of neonatal morbidity and mortality. Early diagnosis is a major problem because of the lack of specific clinical signs. Therefore, a reliable diagnostic marker is needed to guide the use of antimicrobial agents. The objective of our study was to assess the value of proadrenomedullin (pro-ADM) in establishing the diagnosis and evaluating the prognosis of neonatal sepsis.
This study enrolled 60 newborn infants with sepsis proven with positive blood cultures and 30 healthy neonates. Complete blood count, C-reactive protein levels, and pro-ADM levels were obtained from all neonates.
The pro-ADM levels were significantly higher (14.39±0.75 nmol/L) in the sepsis group than in the control group (3.12±0.23 nmol/L). The optimal cutoff value for pro-ADM was 4.3 nmol/L, with a sensitivity of 93.3% and a specificity of 86.7%. The pro-ADM levels were also higher in nonsurvivors (=0.001).
Pro-ADM can be used as a reliable biomarker for neonatal sepsis. High pro-ADM levels were associated with mortality and could be an early indicator of disease outcome.
脓毒症是新生儿发病和死亡的主要原因。由于缺乏特异性临床体征，早期诊断是一个主要问题。因此，需要一种可靠的诊断标志物来指导抗菌药物的使用。我们研究的目的是评估前肾上腺髓质素（pro-ADM）在新生儿脓毒症诊断及预后评估中的价值。
本研究纳入60例血培养阳性确诊为脓毒症的新生儿及30例健康新生儿。所有新生儿均进行血常规、C反应蛋白水平及pro-ADM水平检测。
脓毒症组pro-ADM水平（14.39±0.75 nmol/L）显著高于对照组（3.12±0.23 nmol/L）。pro-ADM的最佳截断值为4.3 nmol/L，敏感性为93.3%，特异性为86.7%。非存活者的pro-ADM水平也更高（P=0.001）。
Pro-ADM可作为新生儿脓毒症的可靠生物标志物。高pro-ADM水平与死亡率相关，可能是疾病预后的早期指标。
