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目的探讨血清可溶性髓系细胞触发受体-1(sTREM-1)、C-反应蛋白(CRP)在新生儿败血症早期诊断及疗效判断上的作用。方法选取足月新生儿120例为研究对象,分确诊败血症组(确诊组)20例、临床诊断败血症组(临床诊断组)35例及非败血症组(对照组)65例。比较确诊组、临床诊断组和对照组新生儿之间的血清sTREM-1及CRP的差异,比较败血症组(确诊组+临床诊断组)和对照组2、6、72 h新生儿血清sTREM-1及CRP的差异。结果确诊组、临床诊断组新生儿血清sTREM-1和CRP水平均明显高于对照组,差异有统计学意义(P<0.05)。败血症组血清sTREM-1在发病第2 h开始升高,6 h达高峰期,有效治疗后于72 h逐渐恢复正常;血清CRP在发病第2 h无明显变化,6 h开始升高,有效治疗后于72 h逐渐下降。结论 sTREM-1、CRP参与炎症反应,且两者水平与感染严重程度相关,sTREM-1早期诊断新生儿败血症及疗效判断的价值高于CRP。
Objective To investigate the role of serum soluble myeloid cell trigger receptor-1 (sTREM-1) and C-reactive protein (CRP) in early diagnosis and therapeutic efficacy of neonatal sepsis. Methods A total of 120 full-term newborns were enrolled in this study. Twenty cases were diagnosed as sepsis (confirmed group), 35 cases were clinically diagnosed as sepsis (clinical diagnosis) and 65 were non-sepsis (control group). The differences of sTREM-1 and CRP levels between neonates diagnosed, clinically diagnosed and control neonates were compared. Serum sTREM-1 levels in sepsis group (diagnosed group + clinical diagnosis group) and control group at 2,6,72 h were compared And CRP differences. Results Serum levels of sTREM-1 and CRP in the diagnosed group and clinical diagnosis group were significantly higher than those in the control group (P <0.05). Serum sTREM-1 in sepsis group began to rise at 2 h, peaked at 6 h, returned to normal at 72 h after effective treatment. Serum CRP did not change significantly at 2 h after onset, and began to rise at 6 h. After 72 h gradually decreased. Conclusion The expression of sTREM-1 and CRP are involved in the inflammatory reaction, and the levels of sTREM-1 and CRP are correlated with the severity of infection. The value of sTREM-1 for the early diagnosis of neonatal sepsis and its efficacy is higher than that of CRP.