Jurges E S, Henderson D C
Department of Child Health, Charing Cross & Westminster Medical School, London, UK.
Clin Exp Immunol. 1996 Sep;105(3):551-5. doi: 10.1046/j.1365-2249.1996.d01-789.x.
Newborn infants often suffer from bacterial and viral infections without presenting typical symptoms. Therefore, reliable methods for detecting and monitoring sepsis in the newborn would be beneficial. In older patients C-reactive protein (CRP) and neopterin have proved useful serum markers of infection and inflammation. Both of these markers are regulated by cytokines, and it has been proposed that cytokines themselves could be used to monitor immune activation and infection. This study has examined the levels of CRP, neopterin, soluble IL-2R, tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) in cord blood samples from both premature and term neonates. Having established reference ranges for these analytes, serial measurements were made in babies requiring intensive care support. The results suggest that in preterm infants the simultaneous measurement of CRP and neopterin, and possibly soluble IL-2R, may provide an accurate early diagnosis of sepsis and may be of use in differentiating between bacterial and viral etiologies. In addition, serial measurement of these markers may help in the early diagnosis of necrotizing enterocolitis (NEC).
新生儿常患细菌和病毒感染却不表现出典型症状。因此，可靠的新生儿败血症检测和监测方法将大有裨益。在年长患者中，C反应蛋白（CRP）和新蝶呤已被证明是有用的感染和炎症血清标志物。这两种标志物均受细胞因子调节，有人提出细胞因子自身可用于监测免疫激活和感染。本研究检测了早产和足月新生儿脐带血样本中CRP、新蝶呤、可溶性白细胞介素-2受体（sIL-2R）、肿瘤坏死因子-α（TNF-α）和干扰素-γ（IFN-γ）的水平。在确定了这些分析物的参考范围后，对需要重症监护支持的婴儿进行了系列测量。结果表明，对于早产儿，同时检测CRP和新蝶呤，可能还有可溶性白细胞介素-2受体，或许能提供败血症的准确早期诊断，且可能有助于区分细菌和病毒病因。此外，对这些标志物进行系列测量可能有助于坏死性小肠结肠炎（NEC）的早期诊断。
