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目的探讨脂多糖结合蛋白(LBP)在胎膜早破早产儿感染早期诊断中的预测价值。方法将惠州市中心人民医院新生儿科2015年1月至2015年8月收治的93例胎膜早破早产儿按出院诊断分成感染组(45例)和非感染组(48例),在出生后24 h内检测两组早产儿LBP水平,与超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白介素-6(IL-6)水平进行比较,绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),评估各项指标对胎膜早破早产儿早发感染的诊断价值。另外感染组按疾病严重程度再分为重症感染组(21例)和一般感染组(24例),检测两组早产儿LBP水平,评估LBP对胎膜早破早产儿早发感染的诊断价值。结果感染组LBP、PCT、IL-6水平高于非感染组,差异有统计学意义(P<0.05);感染组hs-CRP水平低于非感染组,差异无统计学意义(P>0.05);重症感染组LBP水平高于一般感染组,差异有统计学意义;在诊断胎膜早破早产儿早发感染中,LBP的AUC(0.974)最高,PCT(0.694)第2,IL-6(0.588)第3,hs-CRP(0.478)最低。结论胎膜早破早产儿感染早期LBP水平明显升高,与hs-CRP、PCT、IL-6相比,特异性及敏感性方面均具有优越性,可以作为早期诊断胎膜早破早产儿细菌感染的敏感指标。LBP水平可以评估胎膜早破早产儿早发感染的严重程度。
Objective To investigate the predictive value of lipopolysaccharide binding protein (LBP) in the early diagnosis of premature rupture of membranes. Methods 93 cases of preterm premature rupture of membranes from January 2015 to August 2015 in the Department of Neonatology, Huizhou Central People’s Hospital were divided into infection group (n = 45) and non-infection group (n = 48) according to discharge diagnosis. After birth The level of LBP in two groups of preterm infants was measured within 24 h, compared with the levels of hs-CRP, PCT and IL-6, and the working characteristic curve of the subjects was drawn (ROC), calculate the area under the curve (AUC), to assess the diagnostic value of various indicators of premature infants with premature rupture of membranes. In addition, the infection group was further divided into severe infection group (21 cases) and general infection group (24 cases) according to the severity of disease. The LBP level in two groups of preterm infants was detected to evaluate the diagnostic value of LBP in premature infants with premature rupture of membranes. Results The levels of LBP, PCT and IL-6 in the infected group were significantly higher than those in the non-infected group (P <0.05). The hs-CRP level in the infected group was lower than that in the non-infected group (P> 0.05) ; The LBP level in severe infection group was higher than that in general infection group, the difference was statistically significant. Among the premature infants with premature rupture of membranes, LBP had the highest AUC (0.974), PCT (0.694), IL-6 0.588) 3rd, hs-CRP (0.478) lowest. CONCLUSION: LBP levels in preterm premature infants with premature rupture of membranes are significantly higher than those in preterm premature infants, which is superior to hs-CRP, PCT and IL-6 in specificity and sensitivity and can be used as an early diagnosis of premature rupture of membranes Sensitive indicators of infection. The level of LBP can assess the severity of premature infants with premature rupture of membranes.