The Clinical Value Of Interleukin-6in The Early Diagnosis Of Neonatal Septicemia And A Case-control Study On Risk Factors For Early-onset Neonatal Septicemia

Objective To evaluate the clinical value of serum interleukin-6concentration in theearly diagnosis of the neonatal septicemia.Method Between May2011and December2011,120neonates with ages from birthto28days whose course of disease were in24h were collected.The study populationwere divided into four groups(risk sepsis group、no-risk sepsis group、risk controlgroup、no-risk control group) according to the diagnositic criteria of septicemia andthe criteria of neonatal critical illness score.The blood samples including the serumconcentration of IL-6and hs-CRP,blood cell count,blood culture were collected atthe time point which had been designed.The data obtained were subjected to statisticalanalysis.Result When IL-6cut-off is assigned at146.8pg/ml,IL-6is a better marker withhigher sensitivity(98%)、specificity(94%)、positive predict value(92.3%)、negativepredict value(98.5%) and The area under the curve (0.982),compared with hs-CRP(70%、79%、71%、79%、0.725).The serum concentration of IL-6is related to the scoreof neonatal cirtical illness,the less score,the higher IL-6serum contration(r=-0.356,P=0.00).The level of hs-CRP is increased in sepsis group after24hours,there is no statistical significant difference between hs-CRP and IL-6,the combinationof these two marks is confirmed to be more meaningful. The variation of IL-6contra-tion can reflect the clinical change of disease in time.Conclusion It was demonstrated that IL-6might be a good laboratory marker in theearly diagnosis of neonatal septicemia and provide reference to neonatal criticalillness score. Objective The study aimed to identify the risk factors for early-onset neonatalsepsis(EONS) in infants.Methods A case-control study that used a complete randomized block design wasconducted on303infants hospitalized in our deparment during January2010toDecember2011for identifying their risk factors using simple and multivariate logisticregression.The clinical information was compared between153cases with EONS and150cases without EONS.Results Single factor analysis of paired data showed that infants with EONS wassignificantly associated with fetal distress in uterus(OR=4.626),meconium-stainedfluid or foul smelling liquor(OR=3.279),intrapartum fever(OR=4.550), severeasphyxia(OR=4.913),small for gestational age(OR=2.576),parity(OR=1.678),pre-mature rupture of membranes(OR=2.724),chorioamionitis(OR=3.352),pregnancy-induced hypertension(OR=3.967),gestational diabetes mellitus(OR=2.517), abnormalfetal heart rate(OR=5.175).Single factor analysis of Grouped data showed thatgestational age and birth weight are also the risk factors and had the scale effect.Thelogistic regression analysis showed meconium-stained fluid or foul smelling liquor(OR=3.488), fetal distress in uterus(OR=3.193), premature rupture of membranes(OR=3.053), severe gestational age(OR=2.552),pregnancy-induced hypertension(OR=4.636),gestational diabetes mellitus(OR=2.856)and small for gestational agewere the independent risk factors.Pathological jaundice,fever,vomit,abdominaldistention,low response,high white blood cell count,low blood platelets,high C-reactive protein and disseminated intravascular coagulation(DIC) are the main clinicalmanifestation of early-onset neonatal sepsis.Conclusion Multiple factors contribute to EONS during perinatal period,develop aspecific perinatal health care,carry out assessment and identification on neonatalsepsis promptly are the effective way to reduce incidence of EONS in infants.