Vaz F A, Ceccon M E, Diníz E M, Valdetaro F
Departamento de Pediatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo.
Rev Assoc Med Bras (1992). 1998 Jul-Sep;44(3):185-95. doi: 10.1590/s0104-42301998000300005.
Sepsis in the neonatal age is associated with risk factors for infections and with the immunological state of the newborn infant.
Verify if IgM and C-reactive protein were indicators of infection in newborn infants with risk factors.
We studied 57 newborn infants that had: premature rupture of amniotic membranes associated ou no with clinical amniotics or with urinary tract infection. They were classified in three gestational age groups (< 34 weeks, between 34-36 6/7 and (37 weeks) Sepsis diagnosis was made through clinical and laboratorial criterious and we also included: IgM and C-reactive protein obtained of the newborn at birth and at fifth day of life.
Sepsis diagnosis was made in 18 (31.5%) of 57 newborn infants, 13 (22.8%) with early sepsis and 5 (8.7%) with late sepsis. The infection had statistical association with gestational age and with weight at birth. The gestational group < 34 weeks was more infected and in this group the number of newborn that died had association with infection. We did not observed association in the three groups studied between infection and sex. There were significant differences of levels of IgM between infected and not infected newborn infants in the same group of gestational age, this difference was more evident in the fifth day. There were association between levels of C-reactive protein > 10 mg/L and infection in the three groups studied.
C-reactive protein was the better indicator of infection at birth and in the fifth day of life and this was very important for the clinical evolution of the infection and in the late sepsis was the first prove that was altered.
新生儿败血症与感染危险因素及新生儿的免疫状态有关。
验证IgM和C反应蛋白是否为有危险因素的新生儿感染的指标。
我们研究了57例新生儿，这些新生儿有：胎膜早破，伴有或不伴有临床羊膜炎或尿路感染。他们被分为三个孕周组（<34周、34 - 36⁶/₇周和≥37周）。通过临床和实验室标准进行败血症诊断，我们还纳入了：新生儿出生时及出生后第5天的IgM和C反应蛋白。
57例新生儿中有18例（31.5%）被诊断为败血症，13例（22.8%）为早发型败血症，5例（8.7%）为晚发型败血症。感染与孕周和出生体重有统计学关联。<34周的孕周组感染率更高，且该组中死亡的新生儿数量与感染有关。在研究的三组中，未观察到感染与性别之间的关联。在相同孕周组中，感染和未感染的新生儿之间IgM水平存在显著差异，这种差异在第5天更为明显。在研究的三组中，C反应蛋白水平>10mg/L与感染之间存在关联。
C反应蛋白是出生时及出生后第5天感染的更好指标，这对感染的临床进展非常重要，在晚发型败血症中是第一个发生改变的证据。
