| Objective:The purpose of this study is to explore the diagnostic value of serum s TREM-1,IL-6 and PCT alone and combined detection in neonatal early-onset sepsis and analyze the risk factors of neonatal early-onset sepsis,in order to provide a new idea for clinical diagnosis of neonatal early-onset sepsis.Methods:The study selected 115 neonates admitted to our hospital’s neonatal ward and intensive care unit from July 2021 through October 2022 for the present study,55 newborns with early-onset sepsis were included in the EOS group,and 60 newborns with non-infectious diseases in the same period were included in the control group.The clinical data of the two groups of newborns and their mothers during pregnancy were collected.Blood samples were taken before treatment in both groups,and the levels of serum s TREM-1 and IL-6 were detected by double antibody sandwich enzyme-linked immunosorbent assay(Elisa),the level of serum PCT was measured by automatic electrochemical luminescence instrument.The clinical data of newborns and their mothers in the EOS group and the control group were compared,the differences of serum s TREM-1,IL-6 and PCT levels between the two groups were analyzed.The diagnostic efficiency of alone and combined detection of each biomarker was evaluated by drawing the receiver operating characteristic curve to calculate the area under curve and the best cut-off value,and to calculate the sensitivity,specificity,positive predictive value and negative predictive value.The factors with statistically significant differences in univariate analysis were included in multivariate logistic regression analysis for risk factors analysis.P<0.05 was considered to be statistically significant.Results:1、Compared with the control group,the incidences of premature rupture of membranes≥18h,meconium stained amniotic fluid,intra-amniotic infection,anemia in pregnancy,intrapartum fever and vaginal pathogen colonization in EOS group were significantly higher than those in control group(P<0.05).There were no significant differences in gender,age at blood collection,gestational age and birth weight between the two groups(P>0.05).There were also no statistically significant differences in cesarean delivery,multiple abortions,hypertension in pregnancy and gestational diabetes mellitus in the data of the newborn mothers(P>0.05).2、The levels of serum s TREM-1[214.72(170.29,294.53)pg/m L,IL-6[16.54(15.00,23.78)pg/m L] and PCT[15.92(4.29,33.59)ng/m L] in the EOS group were significantly higher than serum s TREM-1[106.00(86.32,142.32)pg/m L],IL-6[13.06(12.38,15.57)pg/m L] and PCT[1.06(0.25,2.55)ng/m L] in the control group,the differences were statistically significant(P<0.001).3、Spearman correlation analysis showed that serum s TREM-1 was positively correlated with IL-6(r=0.529,P<0.001),s TREM-1 was positively correlated with PCT(r=0.680,P<0.001),IL-6 was positively correlated with PCT(r=0.499,P<0.001)in this study.4、The ROC curve showed that the AUC of serum s TREM-1 for neonatal EOS was0.925,the cut-off value was 152.51pg/m L,the sensitivity was 81.80% and the specificity was 90.00%;the AUC of serum IL-6 was 0.883,the cut-off value was 14.40pg/m L,the sensitivity was 87.30% and the specificity was 80.00%;the AUC of serum PCT was 0.877,the cut-off value was 3.09ng/m L,the sensitivity was 83.60% and the specificity was81.70%;When the two factors are detected jointly,the AUC of s TREM-1+IL-6 for neonatal EOS was 0.958,the sensitivity was 85.50% and the specificity was 96.70%;the AUC of s TREM-1+PCT was 0.937,the sensitivity was 80.00% and the specificity was98.30%;the AUC of IL-6+PCT was 0.940,the sensitivity was 83.60% and the specificity was 95.00%.When the three factors are detected together,the AUC was 0.961,the sensitivity was 87.30% and the specificity was 98.30%.5、The results of multivariate logistic regression analysis showed that maternal anemia in pregnancy,intrapartum fever,elevated serum s TREM-1 and PCT were independent risk factors for neonatal EOS.Conclusions:1、The expression of serum s TREM-1,IL-6 and PCT increased significantly in earlyonset sepsis.The diagnostic value of serum s TREM-1 is better than IL-6 and PCT when tested alone;The diagnostic efficacy of serum s TREM-1+IL-6 was best when the two factors were tested together;The diagnostic value of the three factors combined detection is better than that of single and pairwise combined detection.It is suggested that the diagnosis of neonatal EOS can be improved by combining the three factors,which is worthy of further clinical study.2、Maternal anemia in pregnancy,intrapartum fever,elevated serum s TREM-1 and PCT were independent risk factors for neonatal EOS. |
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