The Evaluation Of The Laboratory Diagnostic Indicators Of Neonatal Sepsis

Objectivewe provide the basis for early diagnosis and clinical treatment,by studying the detection of c-reactive protein(CRP),calcitonin(PCT),neutrophil surface marker CD64 and interleukin 6(IL-6)and interleukin 8(IL-8)diagnostic value in neonatal sepsis.MethodsAdopting the prospective study design,we treated 76 cases of neonatal sepsis patients as sepsis group,while 72 cases of no signs of infection as control group,which were selected in the affiliated hospital of Chengde Medical College during March of 2015 to September of 2016.The sepsis group with improved blood culture.Both of groups were collected venous blood before hospitalized,then compared the differences among the detected C-reactive protein,calcitonin,neutrophil surface marker CD64 and interleukin6 and interleukin 8,and evaluated the general condition by Sequential Organ Failure Assessment(Sequential outraged Failure Assessment,SOFA)Score and Pediatric Critical scoring system(Pediatric Critical Illness Score,PCIS)Score.Through mapping the receiver-operating characteristic curve(receiver operating characteristic curve,the ROC curve),we analyze the value of diagnosis of neonatal sepsis with the single or with multiple indicators.Results24 cases of the sepsis groups of children with blood culture positive,with Gram-positive bacteria accounted for 54.1%,Gram-negative bacteria accounted for 37.5% and fungi accounted for 8.3%.As the quantity of the samples was little,comparative differences had no statistical significance(P>0.05).While the levels of C-reactive protein(CRP),calcitonin(PCT)and neutral grain surface marker CD64 and interleukin-6(IL-6)and interleukin 8(IL-8)of the sepsis groups were higher than control group with the statistically significant difference(P<0.05);And in combination with the sensitivity of the detection index,specific degrees and accuracy were significantly higher than that of single detection PCT and CRP detection,comparative differences are statistically significant(P<0.05).The SOFA score of septicemia group was higher than the control group(P<0.05),and the PCIS score was lower than the control group(P<0.05);The levels and SOFA scores of CRP,PCT,CD64 and IL-6,IL-8were positively correlated,and negatively correlated with PCIS score.The ROC curve analysis showed that: when the CRP intercept point was at 8mg/L,the sensitivity,specific degrees and accuracy were 68.9%,76.5%and72.3% respectively;while the PCT intercept point was at 0.5 ug/L,the sensitivity,specific degrees and accuracy were 93.4%,84.7% and 93.4%respectively;When the CD64 taken at 3099 h,/cell,the sensitivity,specific degrees and accuracy were 94.7%,95.2% and 94.7% respectively;When the IL-6 taken at 32 pg/mL,the sensitivity,specific degrees and accuracy were 85.7%,80.2% and 85.7% respectively;When IL-8 taken at 54pg/m L,the sensitivity,specific and accuracy were 78.1%,64.2% and 78.1%respectively;When CRP+CPT joint diagnosis,the sensitivity,specific degrees and accuracy were 88%,83% and 88% respectively;CRP+ CD64 joint diagnosis,the sensitivity,specific degrees and accuracy were 83.2%,83.5% and 83.2%respectively;CRP+PCT+CD64 joint diagnosis,sensitivity,specific degrees and accuracy were 96.3%,92% and 96.3% respectively;IL-6+IL-8 joint diagnosis,the sensitivity,specific degrees and accuracy were 91.4%,86.3% and 91.4% respectively;IL-6+CD64 joint diagnosis,the sensitivity,specific degrees and accuracy were 85.2%,84.1% and 85.2%respectively;CRP+CD64+IL-6 joint diagnosis,the sensitivity,specific degrees and accuracy were 78.3%,95.6% and 86.4% respectively.ConclusionThe levels of CRP,PCT,CD64,IL-6 and IL-8 in neonatal sepsis group were significantly higher than the control group.The combination of CRP+PCT+CD64 and IL-6+ IL-8 could improve the sensitivity and specificity of diagnosis,which was related with the severity of the disease.CRP,PCT,CD64,IL-6 and IL-8 are the specific inflammatory markers widely used in clinic,the combined diagnosis is of great significance for the early diagnosis and treatment of neonatal sepsis,it is helpful to improve the accuracy of diagnosis,reduce the subjectivity of judgment,for clinicians in the diagnosis of neonatal sepsis to provide the correct and scientific reference value,to reduce its misdiagnosis rate and missed diagnosis rate.and was perfect indicators of the early diagnosis of neonatal sepsis.