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目的:评估乳酸和血清胱抑素C(Cys C)在早产儿败血症病情严重程度和预后中的应用价值。方法:分析我院新生儿科住院治疗的82例早产儿败血症患者,入院后检测动脉血乳酸、Cys C、血小板(PLT)、C反应蛋白(CRP)、血常规及新生儿危重病例评分(NCIS),分别比较死亡组和存活组间以及极危重组、危重组和非危重组间血乳酸、Cys C、PLT、CRP、WBC、NCIS评分的差异。采用Pearson检验分析乳酸、Cys C、PLT、CRP与NCIS评分之间的相关性。结果:死亡组动脉血乳酸、Cys C水平较存活组高(P<0.05),死亡组PLT、NCIS较存活组低(P<0.05);死亡组CRP与存活组比较差异无统计学意义(P>0.05)。极危重组、危重组血乳酸高于非危重组,极危重组血乳酸高于危重组(P<0.05),极危重组Cys C高于危重组及非危重组(P<0.05);极危重组、危重组PLT均低于非危重组(P<0.05),极危重组、危重组CRP均高于非危重组(P<0.05),极危重组NCIS低于危重组及非危重组,危重组NCIS低于非危重组(P<0.05);动脉血乳酸、Cys C及CRP均与NCIS呈负相关(r分别为-0.680、-0.607、-0.589,P<0.05),但PLT与NCIS呈正相关(r=0.610,P<0.05)。结论:血乳酸和Cys C对评估早产儿败血症疾病的严重程度及预后有一定的应用价值。
PURPOSE: To evaluate the value of lactate and serum cystatin C (Cys C) in the severity and prognosis of sepsis in premature infants. Methods: A total of 82 premature infants with sepsis were treated in neonates in our hospital. Arterial blood lactic acid, Cys C, platelet (PLT), C reactive protein (CRP), blood routine and neonatal critical illness score (NCIS) The difference of blood lactic acid, Cys C, PLT, CRP, WBC and NCIS scores between death group and survival group, and between critically ill patients, critically ill patients and non-critically ill patients were compared. Pearson test was used to analyze the correlation between lactic acid, Cys C, PLT, CRP and NCIS scores. Results: The arterial blood lactic acid and Cys C levels in death group were significantly higher than those in survival group (P <0.05), while the PLT and NCIS in death group were lower than those in survival group (P <0.05). There was no significant difference between death group and survival group > 0.05). In the critically ill group, the blood lactic acid in the critically ill group was higher than that in the non - critically ill group, the blood lactate in the critically ill group was higher than that in the critically ill group (P <0.05), and the Cys C in the critically ill group was higher than that in the critically ill group and the non - critically ill group (P <0.05) (P <0.05). The levels of CRP in critically ill patients and those in critically ill patients were significantly higher than those in non-critically ill patients (P <0.05) (P <0.05). The NCIS of arterial blood was negatively correlated with NCIS (r = -0.680, -0.607, -0.589, P <0.05, respectively), but PLT was positively correlated with NCIS (R = 0.610, P <0.05). Conclusion: Lactic acid and Cys C have some value in assessing the severity and prognosis of sepsis in premature infants.