Changes And Clinical Significance Of Serum HBD-2 And SPLA2 Levels In Neonatal Infectious Diseases

Objective:Due to poor barrier function,hypoplasia of lymph nodes,low content of complement components,low production and reserve of neutrophils,and low ability of monocytes to produce cytokines,neonatal infection is usually atypical in clinical manifestations,which is prone to missed diagnosis and misdiagnosis,often leading to two-stage differentiation of antibiotic use: untimely or long exposure,which directly leads to neonatal death,complication rate and increase in drug-resistant strains.Current routine infection detection methods: low positive rate of blood bacterial culture,long time-consuming;White blood cell count,neutrophil ratio,C-reactive protein and procalcitonin results are often affected by physiological factors of age,so it is important to find sensitive,specific,simple and feasible biological markers in order to achieve early prediction of neonatal infectious diseases and dynamic evaluation of efficacy,and guide the rational use of antibiotics.This article discusses the early prediction and efficacy evaluation value of serum HBD-2 and sPLA2 on neonatal infectious diseases by studying the levels of serum human β defensin 2(HBD-2)and secreted phospholipase A2(sPLA2)in neonatal infectious diseases,and hopes to provide a certain theoretical reference for the diagnosis and treatment of neonatal infectious diseases.Methods:1.73 newborns admitted to NORTHERN JIANGSU PEOPLE HOSPITAL within 24 hours after birth from December 2021 to December 2022 were admitted to the neonatal ward and met the inclusion criteria as study subjects,and according to the diagnostic criteria for neonatal infectious diseases in Practical Neonatology(5th Edition),children who met the comprehensive diagnostic criteria for neonatal infectious diseases were included in the infection group,children who did not meet the comprehensive diagnostic criteria for neonatal infectious diseases were included in the non-infectious group,and all selected subjects were not treated with antibiotics before admission.2.1ml of peripheral venous blood was collected at the time of admission,3d admission,and 7d admission,centrifuged and stored in a-80°C refrigerator for testing,and serum HBD-2 and sPLA2 concentrations were determined by enzyme linked immunosorbent assay(ELISA).3.Collect clinical data such as gender,gestational age,birth weight,delivery method,premature rupture of membranes(≥18h),and 1min Apgar score.4.SPSS 22.0 statistical software is used for data analysis,and the measurement data is distinguished by normality test whether it is normally distributed;The measurement data are expressed as mean ± standard deviation((?)±s),and independent sample t-test is used for comparison between the two groups that conform to the normal distribution.Paired sample t test was used for comparison of two time points of the same parameter in the group.The frequency description of the counting data was adopted,and the χ~2 test was used for comparison.The receiver operator characteristic(ROC)was used to determine the predictive value of HBD-2 and sPLA2 on neonatal infection,and the area under the curve(AUC)was greater than 0.7,indicating that there was a certain predictive value.P<0.05 indicates that the difference is statistically significant.Results:1.General data comparison: A total of 35 cases were included in the infected group and 38 cases in the non-infected group.There were no significant differences in gender,gestational age,birth weight,delivery mode,and Apgar score 1 min after birth between the two groups(P>0.05),and there was a significant difference in whether premature rupture of membranes(≥18h)was significant(P<0.05).2.Comparison of serum HBD-2 levels at different time points in the two groups: the serum HBD-2 levels in the infected group were higher than those in the non-infected group at admission,3d on admission,and 7d on admission,respectively,among which the differences at admission and 3d were statistically significant(P<0.05),but there was no significant difference in 7d of admission(P>0.05);the serum HBD-2 level in the infected group gradually decreased with the treatment process,and the level of 7d of admission was lower than that at admission and 3d.The differences were statistically significant(P<0.05),while the difference was not statistically significant(P>0.05)compared with admission 3d.3.Comparison of serum sPLA2 levels at different time points in the two groups: the serum sPLA2 levels of the infected group were higher than those in the non-infected group at admission,3d of admission,and 7d of admission,respectively,among which the differences at admission and 3d were statistically significant(P<0.05),but the difference in 7d of admission was not statistically significant(P>0.05);the serum sPLA2 level of the infected group gradually decreased with the treatment process,and the level of 7d of admission was lower than that at admission and 3d.The differences were statistically significant(P<0.05),while the difference was not statistically significant(P>0.05)compared with admission 3d.4.Efficacy analysis of serum HBD-2,sPLA2 and their combined prediction of neonatal infectious diseases Taking 1-specificity as abscissa and sensitivity as ordinate,the ROC curves of serum HBD-2,sPLA2 and the combination of the two were plotted,and the results showed that the AUC values of serum HBD-2,sPLA2 and the two combined to predict the occurrence of neonatal infectious diseases were 0.789,0.806 and 0.844,and the sensitivity was 77.8%,72.2% and 61.1%,respectively.The specificity was 80.0%,80.0%,and 90.0%,respectively.The AUC values of 3d serum HBD-2 and sPLA2 on admission and the combined prediction of neonatal infectious diseases were 0.744,0.794 and 0.822,and the sensitivity was 88.9%,77.8% and 61.1%,respectively.The specificity was 60.0%,80.0%,and 90.0%,respectively.Conclusions:1.Elevated serum HBD-2 and sPLA2 levels in newborns after birth may indicate neonatal infection.2.Serum HBD-2 and sPLA2 can predict neonatal infection early,but the combined detection of serum HBD-2 and sPLA2 is better than that of single serum HBD-2 and sPLA2,and has high sensitivity and specificity.3.Changes in serum HBD-2 and sPLA2 levels can assess the outcome of neonatal infection.