The Clinical Relevance Of Supar In Neonates With Sepsis

Objective To investigate the clinical relevance of serum suPAR by analyzing its levels and changes in neonates with sepsis.Methods Between May 2014 and Juanuary 2015, the study population included all consecutive neonates admitted to the first hospital of Chenzhou affiliated to Nanhua University with the suspected diagnosis of infection within 24 hours(were evaluated on the first day after onset of inflammatory symptoms). Of all the neonates, 65 with identified infecton were classified as sepsis and non-sepsis group on the basis of symptoms and laboratory findings, and divided into the survive and death group within 10 day’s treatment. The group of sepsis were divided into culture-positive and culture-negative group.Health neonates enrolled in Child health unit served as controls.Blood samples of the 65 neonates were collected for culture measurements on the first day, the serum suPAR and CRP measurements were analyzed on day 1,day 4 and day 10, respectively. The controls were performed serum suPAR and CRP analysis on day 1. Data obtained by measurements were compared among groups, the receiver-operating characteristic(ROC) curve analyse was performed according to serum suPAR levels on day 1.Results ⑴On day 1, the serum suPAR and CRP levels of infected patients were significantly higher than that of controls(P<0.05). The serum suPAR levels were significantly more elvated in sepsis group than non-sepsis group. ⑵The sepsis group had significantly higher serum suPAR levels than non-sepsis group On day 4.But serum suPAR levels did not differ between the two groups on day 10.As compared with non-sepsis group, CRP levels at day 4 were significantly higher in sepsis group(P<0.05),but no diferences showed statistically at day 1 and day 10(P>0.05). ⑶In sepsis group,the levels of serum su PAR on day 1 were significantly higher than that on day 10,the levels of CRP on day 4 were significantly higher than that on day 10(P<0.05).In non-sepsis group,the serum suPAR and CRP levels showed no statistically significant differences on day1,day 4 and day 10(P>0.05). ⑷The serum suPAR levels of death group were significantly higher than that of survive group(P<0.05). As comparied with CRP levels,there were no diferences found between two groups(P>0.05). ⑸On day 1,the serum suPAR and CRP levels had no significantly diferences between culture-positive and culture-negative group(P>0.05). ⑹The receiver-operating characteristic(ROC) curve analyse was performed according to suPAR on day 1,when AUC was 0.955,the cut-off ponints of suPAR level was 10.76ng/ml,the sensitivity and specificity were 90% and 100%,respectively.Conclusions An elevated serum suPAR level could be detected in the early stage of neonatal sepsis,especially in death group,had high sensitivity and specificity for the diagnosis and have predictive value for outcome.