探讨血清间α抑制蛋白(IαIP)和嗜中性粒细胞CD₆₄对新生儿败血症的早期诊断价值。

对2009年12月至2011年11月于本院新生儿科住院(住院时间≥7 d)的132例患儿，按照相关疾病诊断标准，分别将其纳入败血症组(n＝43)，感染组(n＝39)及非感染组(n＝50)。所有患儿于入院6 h，12 h及24 h内检测血清IαIP，嗜中性粒细胞CD₆₄，超敏C反应蛋白(hsCRP)；比较单独及联合检测IαIP，嗜中性粒细胞CD₆₄对早期诊断新生儿败血症的灵敏度、特异度、阳性预测值和阴性预测值(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与之签署临床研究知情同意书)。3组患儿性别、胎龄、出生体重、Apgar评分、出生时是否合并窒息、基础疾病(新生儿呼吸窘迫综合征等)、机械通气治疗等比较，差异均无统计学意义(P>0.05)。

①入院6 h，12 h及24 h内血清IαIP值比较，败血症组较感染组、非感染组明显减低，差异有统计学意义(P<0.05)；感染组较非感染组减低，差异有统计学意义(P<0.05)。②入院6 h，12 h及24 h内CD₆₄比较，败血症组较感染组、非感染组升高，差异有统计学意义(P<0.05)；感染组较非感染组升高，差异有统计学意义(P<0.05)。③若以IαIP<167 mg/L为阳性判断标准，则灵敏度和特异度分别为92.76%，87.34%；若以CD₆₄>3894/cell为阳性标准，则灵敏度和特异度分别为97.34%，82.87%。

联合检测IαIP，CD₆₄，可作为新生儿败血症的早期诊断的可靠指标。

To study the clinical significance of inter-α inhibitor protein(IαIP) and neutrophil CD₆₄ in newborns for early diagnosis of neonatal sepsis.

This was a prospective observational study with institutional ethics approval and written maternal consent.A total of 132 patients who were hospitalized in neonatal intensive care unit(NICU) in our hospital from December 2009 to November 2011 were divided into sepsis group(n=43), bacteria infection group(n=39)and non-infection group(n=50). IαIP, neutrophil CD₆₄ and high-sensitivity C-reactive protein (hsCRP) were measured within 6 h, 12 h and 24 h of hospitalization. The sensitivity, specificity, positive predict value (PPV) and negative predict value (NPV) of this three single marker or combined one marker to another were calculated and compared. There had no significant differences among three groups on gender, gestational age at delivery, birth weight, Apgar score, merger of birth asphyxia or not, underlying diseases (hyaline membrane disease, etc.), mechanical ventilation treatment situation (P>0.05).

①Compared to the two other groups, the expression of IαIP within 6 h, 12 h and 24 h of hospitalization at the start of neonatal sepsis were decreased, which was lower than those two other groups, and the difference was statistically significant (P<0.05). And the difference between bacteria infection group and non-infection group were also statistically significant (P<0.05). ②And what was more, the expression of neutrophil CD₆₄ within 6 h, 12 h and 24 h of hospitalization at the start of neonatal sepsis were increased, which was higher than those two other groups (P<0.05). And the difference between bacteria infection group and non-infection group were also statistically significant (P<0.05). ③Examination of IαIP level less than 167 mg/L, the sensitivity and the specificity were 92.76 %, 87.34%, respectively. Examination of neutrophil CD₆₄ levels more than 3894/cell, the sensitivity and the specificity were 97.34 %, 82.87%, respectively.

Combined examination of IαIP and neutrophil CD₆₄ can be taken as a reliable marker for early diagnosing neonatal sepsis., and can get the most useful evidence for the early diagnosis of neonatal sepsis.