C-X3-C趨化因子配體1與新生兒中樞神經(jīng)系統(tǒng)感染的相關(guān)性
發(fā)布時(shí)間：2018-07-29 21:17
【摘要】：目的探討血漿或腦脊液中的C-X3-C趨化因子配體1(CX3CL1)是否可作為判斷中樞神經(jīng)系統(tǒng)感染的指標(biāo)。方法以2015年12月至2016年5月復(fù)旦大學(xué)附屬兒科醫(yī)院新生兒病房中疑診中樞神經(jīng)系統(tǒng)感染行腰椎穿刺檢查的新生兒為感染組,根據(jù)臨床表現(xiàn),腦脊液常規(guī)、生化和培養(yǎng)結(jié)果分為中樞感染亞組、敗血癥亞組和非敗血癥亞組。以同一時(shí)期復(fù)旦大學(xué)附屬婦產(chǎn)科醫(yī)院產(chǎn)科病房健康新生兒為對(duì)照組,根據(jù)出生體重分為2 000、~2 500、~3 000、~3 500和3 500 g亞組,根據(jù)孕周分為33、~35、~37、~39和39周亞組。對(duì)照組取新生兒在出生后的臍帶血;感染組于急性期或穩(wěn)定期行腰椎穿刺檢查,24 h后取靜脈血標(biāo)本。采用Luminex技術(shù)檢測(cè)血或腦脊液標(biāo)本中的CX3CL1水平,比較各組及其亞組間的差異。結(jié)果對(duì)照組69例,感染組24例。中樞感染(化膿性腦膜炎)亞組8例,敗血癥亞組10例,非敗血癥亞組6例(腦積水2例,泌尿系統(tǒng)感染1例,新生兒驚厥2例、高膽紅素血癥伴食管氣管瘺1例)。對(duì)照組臍血CX3CL1水平為(97.8±13.3)pg·mL~(-1),臍血CX3CL1水平在不同體重亞組以及不同孕周亞組間差異無(wú)統(tǒng)計(jì)學(xué)意義,P均0.05。CX3CL1水平在感染組血漿(95.1±8.2)pg·mL~(-1)和對(duì)照組臍血比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.299)。CX3CL1水平感染組腦脊液中(210.0±11.9)pg·mL~(-1)高于血漿,差異有統(tǒng)計(jì)學(xué)意義(P0.001)。感染組中的中樞感染亞組、敗血癥亞組和非敗血癥亞組腦脊液CX3CL1水平分別為(243.1±13.3)、(208.2±20.1)和(168.7±20.6)pg·mL~(-1),3組間差異有統(tǒng)計(jì)學(xué)意義(P=0.046);中樞感染亞組與非敗血癥亞組比較,差異有統(tǒng)計(jì)學(xué)意義(P=0.016);敗血癥亞組與非敗血癥亞組比較(P=0.180)、中樞感染亞組與敗血癥亞組比較(P=0.169),差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論健康新生兒臍帶血和感染新生兒外周血CX3CL1表達(dá)水平相對(duì)穩(wěn)定,不適宜作為判斷是否存在感染的指標(biāo),CSF中CX3CL1作為輔助診斷中樞感染和判斷感染嚴(yán)重程度的分子標(biāo)志物還需進(jìn)一步擴(kuò)大樣本量加以證實(shí)。
[Abstract]:Objective to investigate whether C-X3-C chemokine ligand 1 (CX3CL1) in plasma or cerebrospinal fluid can be used as a marker for central nervous system infection. Methods from December 2015 to May 2016, neonates with suspected central nervous system infection in neonatal ward of affiliated paediatrics hospital of Fudan University were selected as infected group. According to their clinical manifestations, cerebrospinal fluid (CSF) routine was used. Biochemical and culture results were divided into central infection subgroup, septicemia subgroup and non-septic subgroup. The healthy newborns in obstetrical ward of the affiliated Obstetrics and Gynecology Hospital of Fudan University in the same period were taken as the control group. According to their birth weight, they were divided into 2 000 (2 000) and 3 500 g subgroups, and divided into 3 3 ~ (3 +) ~ (35) ~ (3) ~ (5) ~ (7) and 39 ~ (th) week subgroups according to the gestational age. Umbilical cord blood was collected from newborns in the control group, and venous blood samples were collected from the infected group after 24 hours of lumbar puncture examination in the acute or stable phase. Luminex technique was used to detect the level of CX3CL1 in blood or cerebrospinal fluid (CSF). Results there were 69 cases in control group and 24 cases in infection group. Central nervous system infection (suppurative meningitis) subgroup (8 cases), septicemia subgroup (10 cases), non-septicemia subgroup (6 cases) (hydrocephalus 2 cases, urinary tract infection 1 case, neonatal convulsion 2 cases, hyperbilirubinemia with esophagotracheal fistula 1 case). The CX3CL1 level of umbilical cord blood in control group was (97.8 鹵13.3) PG mL ~ (-1). There was no significant difference in CX3CL1 level between different body weight subgroups and different gestational age subgroups. There was no significant difference in plasma (95.1 鹵8.2) PG mL ~ (-1) between infected group and control group (P0.299). CX3CL1 level was not significantly different from that in control group (P0.299). The cerebrospinal fluid (210.0 鹵11.9) PG mL ~ (-1) in infected group was higher than that in plasma. The difference was statistically significant (P0.001). The levels of cerebrospinal fluid (CX3CL1) in central infection subgroup, septicemia subgroup and non-septic subgroup were (243.1 鹵13.3), (208.2 鹵20.l) and (168.7 鹵20.6) PG mL ~ (-1), respectively (P0.046). The difference was statistically significant (P0. 016), there was no significant difference between septicemia subgroup and non septicemia subgroup (P0. 180), central infection subgroup and septicemia subgroup (P0. 169). Conclusion the expression of CX3CL1 in umbilical cord blood and peripheral blood of infected neonates is relatively stable. It is not appropriate to use CX3CL1 as a marker for the diagnosis of central infection and to judge the severity of infection. It is necessary to further expand the sample size to confirm that CX3CL1 is a useful marker for the diagnosis of central infection and the severity of infection.
【作者單位】： 復(fù)旦大學(xué)附屬兒科醫(yī)院新生兒科 衛(wèi)生部新生兒重點(diǎn)實(shí)驗(yàn)室;復(fù)旦大學(xué)附屬婦產(chǎn)科醫(yī)院新生兒科;中國(guó)科學(xué)院神經(jīng)科學(xué)研究所;
【分類號(hào)】：R742.9
[Abstract]:Objective to investigate whether C-X3-C chemokine ligand 1 (CX3CL1) in plasma or cerebrospinal fluid can be used as a marker for central nervous system infection. Methods from December 2015 to May 2016, neonates with suspected central nervous system infection in neonatal ward of affiliated paediatrics hospital of Fudan University were selected as infected group. According to their clinical manifestations, cerebrospinal fluid (CSF) routine was used. Biochemical and culture results were divided into central infection subgroup, septicemia subgroup and non-septic subgroup. The healthy newborns in obstetrical ward of the affiliated Obstetrics and Gynecology Hospital of Fudan University in the same period were taken as the control group. According to their birth weight, they were divided into 2 000 (2 000) and 3 500 g subgroups, and divided into 3 3 ~ (3 +) ~ (35) ~ (3) ~ (5) ~ (7) and 39 ~ (th) week subgroups according to the gestational age. Umbilical cord blood was collected from newborns in the control group, and venous blood samples were collected from the infected group after 24 hours of lumbar puncture examination in the acute or stable phase. Luminex technique was used to detect the level of CX3CL1 in blood or cerebrospinal fluid (CSF). Results there were 69 cases in control group and 24 cases in infection group. Central nervous system infection (suppurative meningitis) subgroup (8 cases), septicemia subgroup (10 cases), non-septicemia subgroup (6 cases) (hydrocephalus 2 cases, urinary tract infection 1 case, neonatal convulsion 2 cases, hyperbilirubinemia with esophagotracheal fistula 1 case). The CX3CL1 level of umbilical cord blood in control group was (97.8 鹵13.3) PG mL ~ (-1). There was no significant difference in CX3CL1 level between different body weight subgroups and different gestational age subgroups. There was no significant difference in plasma (95.1 鹵8.2) PG mL ~ (-1) between infected group and control group (P0.299). CX3CL1 level was not significantly different from that in control group (P0.299). The cerebrospinal fluid (210.0 鹵11.9) PG mL ~ (-1) in infected group was higher than that in plasma. The difference was statistically significant (P0.001). The levels of cerebrospinal fluid (CX3CL1) in central infection subgroup, septicemia subgroup and non-septic subgroup were (243.1 鹵13.3), (208.2 鹵20.l) and (168.7 鹵20.6) PG mL ~ (-1), respectively (P0.046). The difference was statistically significant (P0. 016), there was no significant difference between septicemia subgroup and non septicemia subgroup (P0. 180), central infection subgroup and septicemia subgroup (P0. 169). Conclusion the expression of CX3CL1 in umbilical cord blood and peripheral blood of infected neonates is relatively stable. It is not appropriate to use CX3CL1 as a marker for the diagnosis of central infection and to judge the severity of infection. It is necessary to further expand the sample size to confirm that CX3CL1 is a useful marker for the diagnosis of central infection and the severity of infection.
【作者單位】： 復(fù)旦大學(xué)附屬兒科醫(yī)院新生兒科 衛(wèi)生部新生兒重點(diǎn)實(shí)驗(yàn)室;復(fù)旦大學(xué)附屬婦產(chǎn)科醫(yī)院新生兒科;中國(guó)科學(xué)院神經(jīng)科學(xué)研究所;
【分類號(hào)】：R742.9
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