Analysis Of Risk Factors From Children With Sepsis And The Role Of SCD14-ST On Early Diagnosis And Monitoring

ObjectiveTo analysis the etiology of distribution and the risk factors of neonatal sepsis,and evaluate the role of soluble blood leukocyte differentiation antigen 14-subtypes(sCD14-ST)on early diagnosis and curative efficacy determination for sepsis in children.Methods1,Analysis of the etiology and risk factors of neonatal sepsis by retrospective study96 neonatus with sepsis were collected for exploring the etiology and risk factors of neonatal sepsis,and analyzing the effect of the gestational age,birth weight,mode of parturition on sepsis.2,The role of sCD14-ST on sepsis diagnostic value by case-control study237 children with sepsis(117 cases of bacterial SIRS,120 cases of non bacterial SIRS),89 cases of non infectious SIRS,156 healthy children,were collected for the detection of sCD14-ST,WBC,CRP,PCT,APACHE-II level.The changes of sCD14-ST,WBC,CRP,PCT,APACHE-II level between pre-treatment and post-treatment,as well as the correlation of each index were observed.The ROC was used to analyze the role of sCD14-ST on sepsis diagnosis.3,Determination of sCD14-ST.Chemiluminescence enzyme-linked immune technology was used according to the kit.4,Statistical analysis.IBM SPSS 22.0 software was used for statistical analysis.Results1.E.coli,Staphylococcus aureus,Streptococcus pneumoniae was mainly detected in neonatal sepsis group according to blood culture.2.Univariate analysis showed that the born days,baby weight,parity,gestational age significantly impaired sepsis occurred(P < 0.05),but gender and born way did not show any influence(P > 0.05).Logistic regression analysis showed that the born days was the risk factor for sepsis.3.According to the analysis for 237 children with sepsis,the level of sCD14-ST in infectious SIRS group was significantly higher than that in non infectious SIRS group or healthy control group(X~2=121.850,325.663,P < 0.01).In the infectious SIRS group,there was no significant difference of sCD14-ST level between the bacterial SIRS group and the non bacterial SIRS group(X~2=0.854,P=0.335,though the sCD14-ST level was higher in the SIRS group than that in the health group(X~2=326.228,P < 0.01).4.80 cases form 117 children with bacterial SIRS showed bacterial infection by blood culture.sCD14-ST showed no significant difference between G+ group and G-group(X~2=1.12,P=0.29),but significantly higher than that in health group(X~2=117.46,155.846,P<0.01).5.sCD14-ST showed significant positive correlation with CRP and APACHE-II(R=0.553,0.807,P<0.01),while no find correlation with WBC,PCT(R=0.187,-0.042,P>0.05)before treatment.The levels of sCD14-ST,WBC,CRP,PCT,and APACHE-II score were significantly decreased after treatment than before treatment(X~2=44.569,113.337,63.986,100.055,51.015,P<0.01).6.ROC curve area of sCD14-ST in children with sepsis was 0.901,and it was significantly different with that of CRP and WBC(0.875,0.836),Z=-8.172,-11.398,8.625,P<0.01.The sensitivity and specificity of sCD14-ST detection were respectively 85% and 90%.Conclusion1.Escherichia coli.is the main bacteria in blood culture assay.Born days is a risk factor for neonatal sepsis.2.sCD14-ST assay is one of the laboratory methods for the early diagnosis of children sepsis,and sCD14-ST showed better than other indicators.Combining with APACHE-II scoring system,sCD14-ST could be used to detect the condition children with sepsis.