Li Tiewei, Li Xiaojuan, Wei Yulei, Dong Geng, Yang Jianwei, Yang Junmei, Fang Panpan, Qi Minglu
Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, People's Republic of China.
General Hospital of Taiyuan Steel (Group) Co., Ltd., Taiyuan, 030000, People's Republic of China.
J Inflamm Res. 2021 Jul 13;14:3207-3215. doi: 10.2147/JIR.S321074. eCollection 2021.
Previous studies have reported that C-reactive protein-to-albumin ratio (CAR) was a risk factor for sepsis in adults. However, little is known regarding the role of CAR in neonates with sepsis. The aim of this study was to explore the relationship between CAR and neonatal sepsis.
In this research, from January 2016 to February 2020, a total of 1076 neonates were enrolled at Henan Children's Hospital in China. Complete clinical and laboratory data were collected. To identify the potential independent risk factor for neonatal sepsis, multivariate logistic regression analysis was performed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction accuracy of CAR in identifying neonatal sepsis.
CAR levels were higher in neonates with sepsis and showed a gradual increase among the control group, mild sepsis group and severe sepsis group. The prevalence of neonates with overall sepsis, mild sepsis and severe sepsis increased significantly from CAR tertile 1 to tertile 3. Multiple logistic regression analysis showed that CAR was an independent risk factor for the presence of sepsis (OR = 10.144, 95% CI 4.151-24.790, P < 0.001) and severe sepsis (OR = 1.876, 95% CI 1.562-2.253, P < 0.001). ROC curve analysis showed that CAR had a well discriminatory power in predicting sepsis (area under curve (AUC) = 0.74, 95% CI, 0.71-0.77, P < 0.001) and severe sepsis (AUC = 0.70, 95% CI, 0.67-0.74, P < 0.001).
CAR was an independent predictor for the presence and severity of neonatal sepsis.
既往研究报道，C反应蛋白与白蛋白比值（CAR）是成人脓毒症的一个危险因素。然而，关于CAR在新生儿脓毒症中的作用知之甚少。本研究旨在探讨CAR与新生儿脓毒症之间的关系。
本研究中，2016年1月至2020年2月，中国河南儿童医院共纳入1076例新生儿。收集了完整的临床和实验室数据。为确定新生儿脓毒症的潜在独立危险因素，进行了多因素逻辑回归分析。采用受试者工作特征（ROC）曲线分析来评估CAR在识别新生儿脓毒症中的预测准确性。
脓毒症新生儿的CAR水平较高，且在对照组、轻度脓毒症组和重度脓毒症组中呈逐渐升高趋势。总体脓毒症、轻度脓毒症和重度脓毒症新生儿的患病率从CAR三分位数1到三分位数3显著增加。多因素逻辑回归分析显示，CAR是脓毒症存在的独立危险因素（OR = 10.144，95%CI 4.151 - 24.790，P < 0.001）和重度脓毒症的独立危险因素（OR = 1.876，95%CI 1.562 - 2.253，P < 0.001）。ROC曲线分析显示，CAR在预测脓毒症（曲线下面积（AUC） = 0.74，95%CI，0.71 - 0.77，P < 0.001）和重度脓毒症（AUC = 0.70，95%CI，0.67 - 0.74，P < 0.001）方面具有良好的鉴别能力。
CAR是新生儿脓毒症存在及严重程度的独立预测指标。
