Liu Chunmei, Fang Chengzhi, He Qi, Xie Lili
Department of Neonatology, Renmin Hospital of Wuhan University & Hubei General Hospital, Wuhan, China.
Transl Pediatr. 2020 Oct;9(5):629-635. doi: 10.21037/tp-20-239.
To investigate the value of interleukin-6 (IL-6) for neonates within 6 hours after birth in the prompt diagnosis of early-onset neonatal sepsis (EONS).
The clinical and laboratory data of 129 neonates in the neonatal intensive care unit (NICU) of our center from March 31, 2017, to February 29, 2020, were retrospectively analyzed. These patients were divided into two groups on their disease conditions: the EONS group (n=66) and the healthy control group (n=63). All enrolled patients were born in our hospital's Obstetrics Department and were admitted to the NICU within 2 hours after birth. The first session of the blood test was conducted within 4-6 hours after birth for the measurements of IL-6, C-reactive protein (CRP1), serum amyloid A1 (SAA1), and serum immunoglobulin M (IgM). The second session of the blood test was performed 12-24 hours after birth for procalcitonin (PCT), CRP2, and SAA2. All the tests were completed in our clinical laboratory. The non-parametric test (Mann-Whitney U test) was used to compare all parameters between these two groups. The receiver operating characteristic (ROC) curves were drawn to compare the diagnostic sensitivities and specificities. The pairwise comparisons of the ROC curves were on the MedCalc18.2.1 software. A P value of <0.05 was considered statistically significant.
Gender, birth weight, and gestational age were matched between the EONS group and the control group (all P>0.05). The differences of IL-6, CRP2, PCT, and SAA2 were statistically significant between these two groups (all P<0.05), while there was no significant difference in CRP1, SAA1, and IgM (all P>0.05). The area under the ROC curve (AUC) is 1 (95% CI: 0.918-1.000), 1 (95% CI: 0.918-1.000), 1 (95% CI: 0.918-1.000), and 0.977 (95% CI: 0.878-0.999), respectively, for IL-6, CRP2, PCT, and SAA2. Pairwise comparisons among four biomarkers showed the diagnostic specificity and sensitivity of IL-6 were not significantly different from those of CRP2, PCT, and SAA2 (all P>0.05).
IL-6 is a quick and independent diagnostic biomarker for EONS, and its sensitivity and specificity are inferior to the conventional inflammation markers, including CRP, PCT, and SAA.
探讨出生6小时内新生儿白细胞介素-6（IL-6）在早发型新生儿败血症（EONS）快速诊断中的价值。
回顾性分析2017年3月31日至2020年2月29日在我院新生儿重症监护病房（NICU）的129例新生儿的临床和实验室资料。根据病情将这些患者分为两组：EONS组（n = 66）和健康对照组（n = 63）。所有入选患者均在我院产科出生，出生后2小时内入住NICU。出生后4 - 6小时进行首次血液检测，测定IL-6、C反应蛋白（CRP1）、血清淀粉样蛋白A1（SAA1）和血清免疫球蛋白M（IgM）。出生后12 - 24小时进行第二次血液检测，测定降钙素原（PCT）、CRP2和SAA2。所有检测均在我院临床实验室完成。采用非参数检验（Mann-Whitney U检验）比较两组间所有参数。绘制受试者工作特征（ROC）曲线比较诊断敏感性和特异性。ROC曲线的两两比较在MedCalc18.2.1软件上进行。P值<0.05被认为具有统计学意义。
EONS组与对照组在性别、出生体重和胎龄方面匹配（所有P>0.05）。两组间IL-6、CRP2、PCT和SAA2差异有统计学意义（所有P<0.05），而CRP1、SAA1和IgM无显著差异（所有P>0.05）。IL-6、CRP2、PCT和SAA2的ROC曲线下面积（AUC）分别为1（95%CI：0.918 - 1.000）、1（95%CI：0.918 - 1.000）、1（95%CI：0.918 - 1.000）和0.977（95%CI：0.878 - 0.999）。四种生物标志物的两两比较显示，IL-6的诊断特异性和敏感性与CRP2、PCT和SAA2无显著差异（所有P>0.05）。
IL-6是EONS的快速独立诊断生物标志物，其敏感性和特异性低于包括CRP、PCT和SAA在内的传统炎症标志物。
