Expression And Significance Of Neutrophil CD11b, CD64 And Serum SICAM-1, SE-selectin In Neonatal Sepsis

Objective:Neonatal sepsis is a common disease in neonatal period and the sepsis-related mortality rate is still high. Until now, there has no ideal diagnostic marker to early identify neonatal sepsis. This study aimed to evaluate the diagnostic utilities of two neutrophil antigens(CD11b and CD64) and two soluble adhesion molecules (sICAM-1 and sE-selectin) for early identification of neonatal sepsis related to bacterial infection, and to choose one ideal diagnostic marker to early identify neonatal sepsis. Methods: The group of sepsis consisted of 36 newborns in which 21 were male, and 15 were female, with gestational age of 37~42 weeks, body weight of 2.25~4.0kg, postnatal age of 2~11 days, without asphyxia. Eight of the 36 cases had positive blood culture. The group of noninfection consisted of 22 newborns who were with hypoxic-ischemic encephalopathy or intracrannial hemorrhage,without infection. The control group included 26 healthy newborns, whose sex, weight and age matched with the group of sepsis and noninfection. The blood samples were obtain just into hospital and recovery stage in the group of sepsis and noninfection, and were collected only once in the control. In sepsis group, samples were also taken for bacterial culture before treatment. CD11b and CD64 were quantified with the whole blood flow cytometry and direct immunofluorescence technique, sICAM-1 and sE-selectin were determined by ELISA technique. We also mearured C-reactive protein(CRP) and leukocyte count. The data were dealt with SPSS12.0, and were described in (x±s). P values < 0.05 was considered to be statistically significant. One way analysis of variance(ANOVA), paired-samples T test, Pearson correlation analysis, ROC curve were used for statistical analysis. The sensitivity, specificity, positive and negative predictive values, Youden's index of CD11b, CD64, sICAM-1, sE-selectin and CRP were calculated. Results 1 The changes of CD11b, CD64, sICAM-1 and sE-selectin among the groups of sepsis, noninfection and the control. 1.1 The expression of CD11b in neonates with sepsis, noninfection and the control were (1645.14±463.68)MFI, (1101.49±333.83)MFI and (1041.48±260.34)MFI. There was significant difference among the three groups(F=12.954, P<0.001). CD11b in the group of sepsis was higher than that of noninfection and the control(P<0.01). There was no marked difference between the group of noninfection and the control(P>0.05). 1.2 The expression of CD64 in neonates with sepsis, noninfection and the control were (60.37±22.70)MFI, (27.91±4.91)MFI and (23.14±5.10)MFI. There was significant difference amongthe three groups(F=26.947, P<0.001). CD64 in the group of sepsis was higher than that of noninfection and the control(P<0.01). There was no marked difference between the group of noninfection and the control(P>0.05). 1.3 The content of sICAM-1 in neonates with sepsis, noninfection and the control were (240.20±130.46)ng/ml, (76.95±37.15)ng/ml and (100.24±51.03)ng/ml. There was significant difference among the three groups(F=14.144, P<0.001). The content of sICAM-1 in the group of sepsis was higher than that of noninfection and the control(P<0.01). There was no marked difference between the group of noninfection and the control(P>0.05). 1.4 The content of sE-selectin in neonates with sepsis, noninfection and the control were (29.6±9.9)ng/ml, (22.4±8.9)ng/ml and (14.1±5.3)ng/ml. There was significant difference among the three groups(F=13.544, P<0.001). There were marked difference between the group of sepsis and noninfection(P<0.01), the group of sepsis and the control(P<0.01), and the group of noninfection and the control(P<0.05). 1.5 The content of CRP in neonates with sepsis, noninfection and the control were (23.73±19.70)mg/l, (6.46±2.69)mg/l, (3.61±1.84)mg/l. There was significant difference among the three groups(F=9.281, P<0.001). There were marked difference between the group of sepsis and noninfection(P<0.01), the group of sepsis and the control(P<0.01), and the group of noninfectionand the control(P<0.05). 2 The cha...