Abstract: Objective To compare the significance of IL-6 and C reactive protein (CRP) in early diagnosis and prognosis of neonatal sepsis,and to timely detect neonates in high-risk of infection. Methods A total of 80 neonatal sepsis patients from January 2009 to December 2012 in NICU who met the criteria were included,and 80 cases of non-sepsis were set as the control group.After admission,blood was collected before use of antibiotics,and then submitted for CRP,IL-6 detection,blood routine examination and blood culture.The CRP and IL-6 were reviewed at 4 h,24 h after the use of antibiotics for patient in the case group and control group. Results 1) There were significant differences (P<0.05) between the sepsis group and the control group for the IL-6 and CRP.After 4 h of the antibiotics usage,IL-6 increased significantly to a peak;whereas CRP peaked at 24 h after the antibiotics usage.2) In premature and full-term neonates group,the diagnosis sensitivity and specificity of IL-6 were significantly higher than CRP after 4 h of the antibiotics usage. Conclusions IL-6 has a high sensitivity and specificity for the early diagnosis of neonatal sepsis.IL-6 monitoring at 4 h after infection is most sensitive,and CRP is most sensitive at 24 h after infection.Abnormally high levels of IL-6 increased early than CRP.

Key words: neonatal septicemia, interleukin 6, C reactive protein, early diagnosis

摘要： 目的 比较IL-6与CRP在早期诊断新生儿感染尤其是新生儿败血症的价值预后评估的意义,以及早发现发生感染的高危患儿。方法 在2009年1月-2012年12月的80例新生儿细菌性败血症患儿,另设立非败血症对照组80例。入院后在使用抗生素前对病例组及对照组送检CRP、IL-6、血常规及血培养,在使用抗生素后4 h、24 h复查CRP、IL-6。结果 1)败血症组在使用抗生素后4 h的IL-6显著增加达到高峰;在使用抗生素后24 h的CRP达到高峰。2)在早产儿败血症和足月儿败血症组,IL-6在发病后4 h时的诊断的敏感性和特异性均明显高于CRP。结论 IL-6在早期诊断新生儿败血症上具有较高的敏感性、特异性,在感染后4 h监测血IL-6水平最敏感,而CRP在感染后24 h最敏感,炎性分子IL-6的异常增高早于CRP的异常增高。

关键词: 新生儿败血症, 白细胞介素6, C反应蛋白, 早期诊断