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健康足月和早产儿出生后第 1 至 28 天内,无感染时可溶性 CD14 亚型前肽(presepsin)的参考范围与胎龄和出生后日龄的关系。

Reference ranges of presepsin (soluble CD14 subtype) in term and preterm neonates without infection, in relation to gestational and postnatal age, in the first 28 days of life.

机构信息

Division of Neonatology, Department of Pediatrics, Ege University Faculty of Medicine, Izmir, Turkey.

Department of Biochemistry, Ege University Faculty of Medicine, Izmir, Turkey.

出版信息

Clin Biochem. 2020 Mar;77:7-13. doi: 10.1016/j.clinbiochem.2019.12.007. Epub 2019 Dec 13.

Abstract

OBJECTIVE

To determine the reference ranges of presepsin in term and preterm neonates without infection, with respect to gestational and postnatal age, within the first 28 days of life.

METHODS

A total of 144 neonates born at 24-42 weeks' gestation, including healthy term and preterm neonates without clinical signs or symptoms of infection, were included in this prospective observational study. Presepsin measurements included cord blood levels and serum levels on postnatal days 1, 3, 5, 7, 14, 21, and 28.

RESULTS

The presepsin values corresponding to the 10th percentile ranged from 240.8 pg/mL (on day 1) to 129.9 pg/mL (on day 28), whereas those corresponding to the 90th percentile ranged from 725.8 pg/mL (on day 1) to 471.6 pg/mL (on day 28). Significantly higher presepsin levels were observed in cesarean deliveries than in spontaneous deliveries (p: 0.012 to <0.001), in gestational ages ≤ 32 weeks than in gestational ages ≥37 weeks (p: <0.05 to <0.001), and in cases with a maternal history of chorioamnionitis than in those without (p: <0.05 to <0.001).

CONCLUSION

In conclusion, our findings revealed, for the first time, the reference ranges of presepsin in healthy term and preterm neonates without infection with respect to gestational and postnatal age, sex, and body weight. Presepsin levels within the first 28 days of life seem likely to be affected by the type of delivery, gestational and postnatal age, birth weight, and presence of respiratory distress syndrome or maternal chorioamnionitis.

摘要

目的

确定无感染的足月和早产儿在生命的头 28 天内,按胎龄和出生后年龄划分的降钙素原参考范围。

方法

本前瞻性观察研究纳入了 144 名 24-42 周胎龄出生的新生儿,包括无临床感染症状或体征的健康足月和早产儿。降钙素原检测包括脐血水平和出生后第 1、3、5、7、14、21 和 28 天的血清水平。

结果

第 10 百分位数对应的降钙素原值范围为 240.8 pg/mL(第 1 天)至 129.9 pg/mL(第 28 天),第 90 百分位数对应的降钙素原值范围为 725.8 pg/mL(第 1 天)至 471.6 pg/mL(第 28 天)。剖宫产分娩的降钙素原水平明显高于自然分娩(p:0.012 至<0.001),胎龄≤32 周的降钙素原水平明显高于胎龄≥37 周的(p:<0.05 至<0.001),有绒毛膜羊膜炎病史的降钙素原水平明显高于无该病史的(p:<0.05 至<0.001)。

结论

总之,本研究首次确定了无感染的健康足月和早产儿降钙素原在胎龄和出生后年龄、性别和体重方面的参考范围。生命头 28 天内的降钙素原水平似乎受分娩方式、胎龄和出生后年龄、出生体重以及是否存在呼吸窘迫综合征或绒毛膜羊膜炎的影响。

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