超声心动图参数及外周血T淋巴细胞亚群、NF-κB、CD64水平预测新生儿败血症预后的价值

doi:10.3969/j.issn.1671-7171.2024.03.006

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摘要【目的】探讨超声心动图参数及外周血T淋巴细胞亚群、核因子-κB(NF-κB)、簇分化抗原64(CD64)水平预测新生儿败血症预后的价值。【方法】选取2020年1月至2023年2月本院收治的95例新生儿败血症,根据预后情况将其分为存活组(n=80)和死亡组(n=15)。比较两组患儿超声心动图参数[左室短轴缩短率(FS)、升主动脉内径(AAO)、左室射血分数(LVEF)]、心肌损伤标志物[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)]、T淋巴细胞亚群(CD3⁺、CD4⁺、CD8⁺)、NF-κB、CD64水平;采用Logistic多因素回归分析新生儿败血症预后不良的相关影响因素;采用受试者工作特征(ROC)曲线分析心电图指标及实验室指标预测新生儿败血症预后的临床价值。【结果】两组患儿肌酸激酶CK、CK-MB水平比较,差异无统计学意义(P>0.05);存活组FS、AAO及LVEF高于死亡组患儿,差异有统计学意义(P<0.05)。两组患儿CD8⁺水平比较,差异无统计学意义(P>0.05);存活组患儿CD3⁺、CD4⁺水平高于死亡组,NF-κB、CD64水平低于死亡组,差异有统计学意义(P<0.05)。两组患儿中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)水平比较,差异无统计学意义(P>0.05);存活组患儿白细胞计数(WBC)低于死亡组,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示:FS、LVEF、CD64是影响新生儿败血症预后的相关因素(P<0.05)。FS、LVEF、CD64联合预测新生儿败血症预后的ROC曲线下面积为0.948,明显高于各指标单独预测的0.827、0.895和0.877(P<0.05)。【结论】FS、LVEF联合CD64检测对新生儿败血症预后有良好的预测价值,临床可通过密切监测上述指标及时判断新生儿败血症预后,采取相关干预措施。

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	王菲

关键词 ：新生儿脓毒症, 超声心动描记术, T淋巴细胞亚群, NF-κB/血液, 预后

Abstract：【Objective】To explore the value of echocardiographic parameters, peripheral blood T lymphocyte subsets, nuclear factor-κB(NF-κB), and cluster differentiation antigen 64(CD64) levels in predicting the prognosis of neonatal sepsis. 【Methods】 A total of 95 neonatal sepsis patients admitted to our hospital from January 2020 to February 2023 were selected and divided into a survival group(n=80) and a death group(n=15) according to their prognosis. The echocardiographic parameters [left ventricular short axis shortening fraction(FS), ascending aorta diameter(AAO), left ventricular ejection fraction(LVEF)], myocardial injury markers [creatine kinase(CK), creatine kinase isoenzyme(CK-MB)], T lymphocyte subsets(CD3⁺, CD4⁺, CD8⁺), NF-κB, and CD64 levels were compared between the two groups. Logistic multivariable regression analysis was used to analyze the relevant factors affecting the poor prognosis of neonatal sepsis. The receiver operating characteristic(ROC) curve was used to analyze the clinical value of electrocardiogram and laboratory indicators in predicting the prognosis of neonatal sepsis. 【Results】 There was no significant difference in the levels of creatine kinase CK and CK-MB between the two groups(P>0.05). The FS, AAO, and LVEF in the survival group were higher than those in the death group, and the difference was statistically significant(P<0.05). There was no significant difference in the CD8⁺ level between the two groups(P>0.05). The CD3⁺ and CD4⁺ levels in the survival group were higher than those in the death group, while the NF-κB and CD64 levels were lower, and the difference was statistically significant(P<0.05). There was no significant difference in the NLR and CRP levels between the two groups(P>0.05). The WBC level in the survival group was lower than that in the death group, and the difference was statistically significant(P<0.05). Logistic multivariable regression analysis showed that FS, LVEF, and CD64 were related factors affecting the prognosis of neonatal sepsis(P<0.05). The area under the ROC curve for FS, LVEF, and CD64 combined to predict the prognosis of neonatal sepsis was 0.948, which was significantly higher than that of each individual indicator(0.827, 0.895, and 0.877, respectively)(P<0.05). 【Conclusion】The combined detection of FS, LVEF, and CD64 has good predictive value for the prognosis of neonatal sepsis. Clinicians can closely monitor these indicators to timely judge the prognosis of neonatal sepsis and take relevant intervention measures.

Key words： Neonatal Sepsis Echocardiography T-Lymphocyte Subsets NF-kappa B/BL Prognosis

收稿日期: 2023-06-26

中图分类号:

R722.131

引用本文:

王菲. 超声心动图参数及外周血T淋巴细胞亚群、NF-κB、CD64水平预测新生儿败血症预后的价值[J]. 医学临床研究, 2024, 41(3): 340-343.
WANG Fei. The Value of Echocardiographic Parameters, Peripheral Blood T Lymphocyte Subsets, NF-κB, and CD64 Levels in Predicting the Prognosis of Neonatal Sepsis. JOURNAL OF CLINICAL RESEARCH, 2024, 41(3): 340-343.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.03.006 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I3/340

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