摘要
目的探讨25羟维生素D[25(OH)D]、氨基末端脑钠肽前体(NT-proBNP)、降钙素原(PCT)、C反应蛋白(CRP)表达水平与新生儿感染性疾病严重程度的关系,为新生儿感染性疾病早期诊断提供依据。方法选取郑州大学第二附属医院2021年10月-2024年10月收治的128例感染性疾病新生儿为研究组,另选取同期住院非感染新生儿128例为对照组。研究组根据新生儿危重病例评分将其分为极危重组(n=31)、危重组(n=38)、非危重组(n=59)。分析研究组新生儿基础疾病情况,比较研究组和对照组、不同疾病严重程度组血清25(OH)D、NT-proBNP、PCT、CRP水平,通过Pearson进行相关性分析,采用受试者工作特征(ROC)曲线分析血清25(OH)D、NT-proBNP、PCT、CRP水平对新生儿感染性疾病的诊断价值。结果128例新生儿感染性疾病的基础疾病包括肺炎41例占32.03%,消化道疾病28例占21.88%,新生儿黄疸25例占19.53%,新生儿脑膜炎17例占13.28%,脓毒症15例占11.72%,尿路感染2例占1.56%。研究组血清NT-proBNP、PCT、CRP水平均高于对照组,血清25(OH)D水平则低于对照组,差异均有统计学意义(t=131.510、87.027、104.624、28.808,P均<0.05)。极危重组血清NT-proBNP、PCT、CRP水平高于危重组和非危重组,血清25(OH)D水平低于危重组和非危重组,差异均有统计学意义(F=2739.082、85.378、46.641、387.549,P均<0.05)。新生儿感染性疾病严重程度与血清25(OH)D水平成负相关(r=-0.805,P<0.05),与血清NT-proBNP、PCT、CRP水平则成正相关(r=0.629、0.903、0.744,P均<0.05)。血清25(OH)D、NT-proBNP、PCT、CRP水平单一及联合检测评估新生儿感染性疾病的曲线下面积(AUC)分别为0.705、0.773、0.721、0.718、0.921,敏感度分别为62.50%、74.22%、70.31%、76.56%、84.37%,特异度分别为70.31%、71.87%、72.66%、60.16%、81.25%,其中联合检测的AUC最高(P<0.001)。结论血清25(OH)D、NT-proBNP、PCT、CRP水平在新生儿感染性疾病中均呈异常表达,且与患儿病情严重程度具有一定关系,四者联合检测对新生儿感染性疾病具有较高诊断价值。
Objective To explore the relationship between 25⁃hydroxyvitamin D[25(OH)D],N⁃terminal pro⁃brain natriuretic peptide(NT⁃proBNP),procalcitonin(PCT)and C⁃reactive protein(CRP)and the severity of neonatal infectious diseases.Methods A total of 128 cases of neonatal infectious diseases in the Second Affiliated Hospital of Zhengzhou University from October 2021 to October 2024 were selected as the research group.128 cases of non⁃infected newborns were selected as the control group.Among them,the children in the research group were divided into extremely critical group(n=31),critical group(n=38),and non⁃critical group(n=59)according to the neonatal critical case score.The underlying diseases of the newborns in the research group were analyzed.The serum 25(OH)D,NT⁃proBNP,PCT,and CRP levels were compared between the research group and the control group,as well as between the different disease severity groups.Pearson correlation analysis was performed,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum 25(OH)D,NT⁃proBNP,PCT,and CRP levels for neonatal infectious diseases.Results Among 128 cases of neonatal infectious diseases,41 cases were pneumonia,accounting for 32.03%,digestive tract diseases in 28 cases,accounting for 21.88%,neonatal jaundice in 25 cases,accounting for 19.53%,neonatal meningitis in 17 cases,accounting for 13.28%,sepsis in 15 cases,accounting for 11.72%,and urinary tract infection in 2 cases,accounting for 1.56%.The serum levels of NT⁃proBNP,PCT and CRP in the research group were higher than those in the control group.The level of serum 25(OH)D was lower than that of the control group(t=131.510,87.027,104.624,28.808;all P<0.05).Serum NT⁃proBNP,PCT,and CRP levels in the extreme critical group were significantly higher than those in the critical group and non⁃critical group,serum 25(OH)D levels in the extreme critical group were significantly lower than those in the critical group and non⁃critical group(F=2739.082,85.378,46.641,387.549;all P<0.05).The severity of neonatal infection was negatively correlated with serum 25(OH)D levels(r=-0.805,P<0.05)and positively correlated with serum NT⁃proBNP,PCT,and CRP levels(r=0.629,0.903,and 0.744,respectively,all P<0.05).The areas under the curve(AUC)for serum 25(OH)D,NT⁃proBNP,PCT,and CRP levels alone and in combination for evaluating neonatal infectious diseases were 0.705,0.773,0.721,0.718,and 0.921,respectively;the sensitivities were 62.50%,74.22%,70.31%,76.56%,and 84.37%,respectively,and the specificities were 70.31%,71.87%,72.66%,60.16%,and 81.25%,respectively.The combined test had the highest AUC(P<0.05).Conclusions Serum 25(OH)D,NT⁃proBNP,PCT,and CRP levels were all abnormal in neonatal infectious diseases and correlate with the severity of the disease.Combined testing had a high diagnostic value for neonatal infectious diseases.
作者
宋焕清
李晶晶
刘园园
霍志芳
SONG Huanqing;LI Jingjing;LIU Yuanyuan;HUO Zhifang(Department of Paediatrics,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)
出处
《热带医学杂志》
2025年第10期1367-1371,共5页
Journal of Tropical Medicine
基金
河南省医学科技攻关计划项目(LHGJ20240303)。
