摘要
目的探讨血浆受体相互作用蛋白3(receptor interacting protein 3, RIP3)在新生儿晚发型败血症(late-onset sepsis, LOS)中的变化及意义。方法选择2019年10月至2021年4月苏州市立医院新生儿科收治的患儿进行前瞻性研究, 发生LOS的患儿纳入LOS组, 非感染性疾病的患儿纳入对照组, 利用酶联免疫吸附法测定血浆RIP3, 并探讨血浆RIP3在新生儿LOS诊疗中的价值。结果共纳入152例新生儿, 对照组76例, LOS组76例, 两组患儿基线资料差异无统计学意义(P>0.05)。共收集226份血浆样本(对照组76份, LOS组治疗前76份, LOS组治疗后74份)。LOS组治疗前血浆RIP3为(19.9±6.3)ng/ml, 明显高于对照组(11.4±3.5)ng/ml及治疗后(11.9±3.5)ng/ml, 差异有统计学意义(P<0.05);血浆RIP3诊断新生儿LOS的受试者工作特征曲线下面积为0.884, 当血浆RIP3为15.5 ng/ml时具有最佳诊断效能(约登指数为0.658, 诊断敏感度为72.4%, 特异度为93.4%, 阳性似然比为11.0, 阴性似然比为0.3)。结论血浆RIP3水平与新生儿LOS的发生密切相关, 对新生儿LOS的诊断、治疗评估具有潜在应用价值。
Objective To study the changes of plasma receptor interacting protein 3(RIP3)levels in neonatal late-onset sepsis(LOS)and to determine its clinical value.Methods From October 2019 to April 2021,plasma samples and clinical data of LOS infants admitted to our hospital were prospectively studied.Infants with similar gestational ages admitted for non-infectious diseases were assigned into the control group.Enzyme-linked immunoassay was used to determine plasma RIP3 levels.The clinical value of plasma RIP3 in the diagnosis and treatment of neonatal LOS were analyzed.Results A total of 152 cases(76 in the LOS group and 76 in the control group)were included in the study.No significant differences existed in the baseline data between the two groups.A total of 226 plasma samples were collected(76 samples from the LOS group before treatment,74 samples after treatment and 76 samples from the control group).The plasma RIP3 level of LOS group before treatment(19.9±6.3 ng/ml)was significantly higher than the control group(11.4±3.5 ng/ml)and the after treatment group(11.9±3.5 ng/ml)(P<0.05).The plasma RIP3 level had good diagnostic value for neonatal LOS(AUC=0.884).With cut-off value of 15.5 ng/ml,the plasma RIP3 showed the best diagnostic efficacy(Youden index 0.658,sensitivity 72.4%,specificity 93.4%,positive likelihood ratio 11.0,negative likelihood ratio 0.3).Conclusions Plasma RIP3 level is closely related with neonatal LOS and may be used for the early diagnosis and therapeutic evaluation of neonatal LOS.
作者
李俊峰
高楚楚
王三南
杨祖铭
蔡燕
冯宗太
Li Junfeng;Gao Chuchu;Wang Sannan;Yang Zuming;Cai Yan;Feng Zongtai(Department of Neonatology,Suzhou Municipal Hospital,Suzhou 215002,China)
基金
江苏省卫生健康委科研项目(LGY2020045)
苏州市科技发展计划(SYS2019095)
南京医科大学科技发展基金(NMUB2019330)。
