Value Of IL-6 And IL-8 In The Diagnosis Of Neonatal Sepsis

Objective To explore the clinicalvalue ofinterleukin-6(IL-6) and IL-8in the diagnosis of neonatal sepsis.Methods A prospective study conducted between August 2014 and February 2016. A sepsis group(n=90) and a non-septicemic infectiongroup(n=171)were served as observation groups. Another 121 neonates with no clinical or biological data of infectious were served as the control group over the same period. Serum levels of IL-6 and IL-8 were measured for all subjects at the time of admission andneonates with suspected infectious after 3 days of antibiotic treatment, at the same time, CRP, blood routine test, blood culture and other related testing were required.(1)To compare the difference of the levels of serum IL-6, IL-8 and CRP among three groups before treatment and 3 days after treatment; Thechange trend of the three markers’ difference before and after treatment was compared in the sepsis and non-septicemic infection group;(2)The value of serum IL-6, IL-8 and CRP for the diagnosis of neonatal sepsis before treatment was assessed by receiver operating characteristic(ROC) curve analysis;(3)To analyze the value of combined diagnosis in neonatal sepsis;(4)Compare thecombined detection of IL-6 and IL-8 with blood culture in the sepsis group. To analyze the value of three infectious indicators between clinical and laboratory sepsis group. All data were analyzedby SPSS 16 statistical software and draw relevant statistical charts. Normal distribution measurement data were described in( sx ±),t test method,One-Way ANOVA analysis, SNK-q method was used to analyze data.Data which was not in conformity with the normal distribution was described in[M(P25,P75)], Wilcoxon rank sum test, χ2 test, Kruskal-Wallis H test, extended t test method was used toanalyzedata; Count data was expressed in rate(%); ROC curve analysis was used to evaluate the diagnostic performance.P<0.05 was considered as statistically significant.Results 1. Before treatment and after three days of treatment, the serum levels of IL-6, IL-8 and CRP in the sepsis group were higher than those in the non-septicemic infection and control groups(P<0.05);Before treatment, the non-septicemic infection group had higher serum levels of IL-6, IL-8 and CRP than the control group(P<0.05), but there were no statistically significant differences among the groups in the white blood cell counts(P>0.05). After three days of treatment, the levels of IL-6 in non-septicemic infection group was higher than those in the control group(P<0.05), there were no significant difference in the serum IL-8 and CRP levels between the non-septicemic group and the control group(P>0.05); The difference of before and after treatment in the infection group(including sepsis group and non-septicemic group)statistically significant of the serum level of IL-6, IL-8(P<0.05), while there was no significant difference of CRP(P>0.05). The downward trend of serum levels of IL-6 and IL-8 in the infection group declined greater than CRP after treatment. 2.According to the ROC curve, the area under the curve(AUC) of IL-6, IL-8 and CRP in the diagnosis of neonatal sepsis before treatment was 90.9%, 78.1%, 69.1%, respectively. When the cut-off value of serum IL-6 was 28pg/m L, the sensitivity, specificity and accuracyof serum IL-6 for the diagnosis of neonatal sepsis were 91.1%, 81.2% and82.5%, respectively; When the cut-off value of serum IL-8 was 54pg/m L, the sensitivity, specificity and accuracy of serum IL-8 for the diagnosis of neonatal sepsis were 78.9%, 69.9% and 72.5%, respectively; When the cut-off value of serum CRP was 22mg/L, the sensitivity, specificity and accuracy of serum CRP for the diagnosis of neonatal sepsis were 47.8%, 82.9% and 74.6%, respectively. 3.The experiments of combined diagnostic showed IL-6 combined with IL-8 for diagnosis of neonatal sepsis had the highest sensitivity, Youden index, positive predictive value, negative predictive value and accuracy, which were 70%, 0.63,74.1%, 90.9% and 87.2%,respectively; The accuracy and specificity(87.2%, 92.2%) of IL-6 combined with IL-8 in diagnosis of neonatal sepsis were higher than that of IL-6 alone(82.5%, 81.2%). 4. When compared with blood culture, the positive rate of IL-6 combined with IL-8 was 70% in diagnosis of neonatal sepsis, which was higher than that of blood culture positive rate, which was 40.0%, and there was significant difference between two groups(P<0.01). Before treatment, the serum level of IL-8 in the laboratory sepsis group was higher than that in theclinical sepsis group(P<0.05), while there was no significant difference of IL-6 and CRP(P>0.05).Conclusion 1. The detection of the serum level of IL-6and IL-8 are helpful in the diagnosis of neonatal infection,compared with IL-8 and CRP, the sensitivity and accuracy of IL-6 in diagnosis of neonatal sepsis are the highest. 2. IL-6 and IL-8 vary with the severity of infection.The combined detection of serum levels IL-6 and IL-8 mayhelpful to increase the accuracy of diagnosis of neonatalsepsis and guide the clinical application of antibiotics.