目的探讨白细胞介素-6(IL-6)、IL-8在新生儿败血症诊断中的临床价值。方法采用前瞻性研究设计,选取2014年8月至2015年2月患感染性疾病的新生儿共140例(败血症组49例,局部感染组91例)为研究对象,非感染性疾病的新生儿61例作为对照组,比较各组治疗前及治疗3 d后血清中IL-6和IL-8水平的差异,分析各指标诊断新生儿败血症的价值。结果治疗前败血症组IL-6、IL-8水平均高于局部感染组和对照组,IL-6和IL-8在局部感染组中水平均高于对照组(P<0.05);治疗3 d后,败血症组IL-6水平均高于局部感染组和对照组,局部感染组IL-6水平高于对照组(P<0.05),IL-8在各组间差异无统计学意义(P>0.05)。治疗前ROC曲线分析显示:当IL-6取32 pg/mL时,敏感度、特异度和准确性分别为87.8%、79.6%、81.6%;当IL-8取54 pg/mL时,敏感度、特异度和准确性分别为77.6%、63.8%、67.2%;IL-6+IL-8联合诊断时,敏感度、特异度和准确性分别为71.4%、86.2%、82.6%。结论 IL-6、IL-8参与炎症反应,且两者水平与感染严重程度相关,IL-6诊断新生儿败血症的价值高于IL-8,且两者联合应用可提高新生儿败血症诊断的准确性。

Objective To explore the significance of interleukin-6(IL-6) and IL-8 in the diagnosis of neonatal sepsis. Methods This was a prospective study conducted between August 2014 and February 2015. A total of 140 neonates who were suspected infectious were enrolled and classified into a sepsis group (n=49) and a local infection group (n=91). Sixty-one neonates who were non-infectious served as the control group. Serum levels of IL-6 and IL-8 were measured before treatment and 3 days after treatment. The value of serum IL-6 and IL-8 for the diagnosis of neonatal sepsis was assessed by receiver operating characteristic (ROC) curve analysis. Results Before treatment, serum levels of IL-6 and IL-8 in the sepsis group were higher than those in the local infection and control groups (P<0.05), and the local infection group had higher serum levels of IL-6 and IL-8 than the control group (P<0.05). After three days of treatment, the serum IL-6 level in the sepsis group remained higher than that in the local infection and control groups (P<0.05), and the local infection group had higher serum level of IL-6 than the control group (P<0.05). There was no significant difference in the serum IL-8 level among the three groups. According to the ROC curve, when the cut-off value of serum IL-6 was 32 pg/mL, the sensitivity, specificity and accuracy of serum IL-6 for the diagnosis of neonatal sepsis were 87.8%, 79.6% and 81.6% respectively; when the cut-off value of serum IL-8 was 54 pg/mL, the sensitivity, specificity and accuracy of serum IL-6 for the diagnosis of neonatal sepsis were 77.6%, 63.8% and 67.2% respectively. With the combination of serum IL-6 and IL-8 levels, the sensitivity, specificity and accuracy for the diagnosis of neonatal sepsis were 71.4%, 86.2% and 82.6% respectively. Conclusions IL-6 and IL-8 participate in the inflammatory response and the serum levels of both vary with the severity of infection. The diagnostic value of IL-6 for neonatal sepsis is higher than IL-8. The combined detection of serum levels IL-6 and IL-8 may increase the accuracy of diagnosis of neonatal sepsis.