【摘要】 目的 探讨新生儿败血症降钙素原（PCT）、超敏C反应蛋白（hs-CRP）、白介素6(IL-6)表达水平与疾病严重程度的关系及其对患儿并发化脓性脑膜炎的预测价值。方法 选取安徽医科大学附属滁州医院2017年4月至2022年8月97例新生儿败血症患儿纳入败血症组，依照新生儿危重病例评分（NCIS）结果将患儿分为非危重组（n=36例）、危重组（n=33例）、极危重组（n=28）；另选取同期健康新生儿60名作为对照组，比较不同组别血清PCT、hs-CRP、IL-6水平差异，分析血清指标与疾病严重程度的关系，并依照患儿化脓性脑膜炎并发情况将败血症组患儿分为化脑组（n=15）及非化脑组（n=82），分析血清指标对化脓性脑膜炎发生的预测价值。结果 败血症组血清PCT、hs-CRP、IL-6水平高于对照组，差异有统计学意义（t=28.069、19.018、19.512,P<0.05）；不同病情严重程度患儿血清PCT、hs-CRP、IL-6水平比较，极危重组>危重组>非危重组，差异有统计学意义（F=33.271、26.203、23.755,P<0.05）;Spearman相关性分析显示，血清PCT、hs-CRP、IL-6水平与患儿疾病严重程度呈正相关（r=0.617、0.563、0.494,P<0.05）；血清PCT、hs-CRP、IL-6水平联合检测评估非危重组与危重组ROC曲线下面积为0.892，高于各项指标单独检测，联合检测评估危重组与极危重组ROC曲线下面积为0.895，高于各项指标单独检测（P<0.05）；化脑组患儿血清PCT、hs-CRP、IL-6水平高于非化脑组，差异有统计学意义（t=4.024、2.932、3.485,P<0.05）；血清PCT、hs-CRP、IL-6水平联合检测预测患儿化脓性脑膜炎并发情况ROC曲线下面积为0.832，高于各项指标单独检测（P<0.05）。结论 新生儿败血症患儿血清PCT、hs-CRP、IL-6呈现高表达，且其高表达状态与疾病严重程度相关，并可在一定程度上预示患儿化脓性脑膜炎发生风险。更多还原

【Abstract】 Objective To investigate the relationship between the expression levels of procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and the disease severity in neonatal sepsis and their predictive value in children with purulent meningitis. Methods A total of 97 children with neonatal sepsis in Chuzhou Hospital Affiliated to Anhui Medical University from April 2017 to August2022 were selected as the sepsis group. According to the results of neonatal critical illness score(NCIS),the children were divided into the non-critical group(n=36),the critical group(n=33)and the extremely critical group(n=28). Another 60 healthy newborns in the same period were selected as the control group. The differences of serum PCT,hs-CRP and IL-6 levels in different groups were compared,and the relationship between serum indicators and disease severity was analyzed. According to the concurrent situation of purulent meningitis in children,the children in the sepsis group were divided into the purulent meningitis group(n=15)and the nonpurulent meningitis group(n=82),and the predictive value of serum indicators for purulent meningitis was analyzed. Results The levels of serum PCT,hs-CRP and IL-6 in the sepsis group were significantly higher than those in the control group(t=28.069,19.018,19.512,P<0.05). The levels of serum PCT,hs-CRP and IL-6 in children with different severity of illness were compared,and the extremely critical group > the critical group >the non-critical group,the difference was statistically significant(F=33.271,26.203,23.755,P<0.05). Spearman correlation analysis showed that serum PCT,hs-CRP and IL-6 levels were positively correlated with the severity of the disease(r=0.617,0.563,0.494,P<0.05). The area under the ROC curve of combined detection of serum PCT,hs-CRP and IL-6 levels in the non-critical group and the critical group was 0.892,which was higher than that of the individual detection of each indicator. The area under the ROC curve of combined detection in the critical group and the extremely critical group was 0.895,which was higher than that of single detection of each indicator(P<0.05).The levels of serum PCT,hs-CRP and IL-6 in the PM group were higher than those in the non-PM group(t=4.024,2.932,3.485,P<0.05). The area under ROC curve of combined detection of serum PCT,hs-CRP and IL-6 levels in predicting the occurrence of purulent meningitis in children was 0.832,which was higher than that of single detection of each index(P<0.05). Conclusion The serum levels of PCT,hs-CRP and IL-6 in children with neonatal sepsis are highly expressed,and their high expression status is related to the severity of the disease,and can ipredict the risk of purulent meningitis in children to a certain extent.更多还原