血清TLR4、sIL-2R联合HLA-B27水平对不同病原菌感染早产儿预后的预测价值

doi:10.3969/j.issn.1671-7171.2026.04.018

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摘要 【目的】探讨血清Toll样受体4(TLR4)、可溶性白细胞介素-2受体(sIL-2R)联合人白细胞抗原B27(HLA-B27)水平对不同病原菌感染早产儿预后的预测价值。【方法】回顾性分析2022年12月至2025年4月本院收治的197例感染早产儿的临床资料。治疗前,对所有患儿感染标本进行病原菌鉴定。随访至出院,根据早产儿感染预后分成预后不良组(n=31)与预后良好组(n=166)。比较两组患儿血清HLA-B27、sIL-2R、TLR4水平与临床资料,分析早产儿感染预后不良的影响因素,分析各检测指标对早产儿感染预后不良的预测价值。【结果】197例早产儿感染共检出157株病原菌,革兰氏阴性菌、革兰氏阳性菌分别为93株、64株。预后不良组早产儿的血清HLA-B27、sIL-2R、TLR4水平高于预后良好组,差异有统计学意义(P<0.05)。预后不良组住院时间长于预后良好组,新生儿5 min Apgar评分≤7分所占比例高于预后良好组,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析显示,血清HLA-B27、sIL-2R、TLR4单独检测及三者联合预测早产儿感染预后不良的曲线下面积(AUC)分别为0.801、0.846、0.805、0.909(P<0.05),且三者联合预测早产儿感染预后不良的价值更高(P<0.05)。Logistic回归分析显示,血清TLR4＞404.65 mg/L、sIL-2R＞387.21 ng/L、HLA-B27＞99.23 U/mL、新生儿Apgar评分≤7分为早产儿感染预后不良的独立危险因素(均P<0.05)。【结论】血清TLR4、sIL-2R、HLA-B27水平在预测早产儿感染预后中具有重要价值,且三者联合的预测价值更高。

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	郭晓鹤
	康莺歌
	张原景

关键词 ：婴儿, 早产, 感染, Toll样受体4, 受体, 白细胞介素2, HLA抗原, 预后

Abstract：【Objective】 To analyze the predictive value of serum Toll-like receptor 4 (TLR4), soluble interleukin-2 receptor (sIL-2R) combined with human leukocyte antigen B27 (HLA-B27) levels for the prognosis of infection in preterm infants. 【Methods】 A retrospective analysis was conducted on the medical records of 197 premature infants with infections admitted to our hospital from December 2022 to April 2025. Before the treatment, pathogenic bacteria in the infected specimens from all children were identified. The infants were followed up until discharge and they were divided into the good prognosis group (166 cases) and the poor prognosis group (31 cases) according to the prognosis of infection in premature infants. The levels of serum HLA-B27, sIL-2R and TLR4 and the clinical data of the two groups were compared. The influencing factors for poor prognosis of infection in premature infants were assessed; and the predictive values of each detection index for poor prognosis of infection in premature infants were analyzed. 【Results】 A total of 157 pathogenic bacteria were detected in 197 cases of premature infants with infection comprising 93 Gram-negative bacteria and 64 Gram-positive bacteria . Serum TLR4, sIL-2R and HLA-B27 levels in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The length of hospital stay in the poor prognosis group was longer than that in the good prognosis group (P<0.05), and the proportion of newborns with a 5-minute Apgar score of ≤7 in the poor prognosis group was higher than that in the good prognosis group (P<0.05). The ROC curve analysis revealed that the area under the curve (AUC) values of serum TLR4, sIL-2R, HLA-B27 level alone and the combination of the three for predicting poor prognosis of infection in preterm infants were 0.805, 0.846, 0.801, and 0.909 respectively (P<0.05). Moreover, the combined predictive value of these three markers was significantly higher (P<0.05). Logistic regression analysis revealed that serum levels of TLR4 > 404.65 mg/L, sIL-2R > 387.21 ng/L, and HLA-B27 > 99.23 U/mL, as well as a neonatal Apgar score ≤ 7, were independent risk factors for poor prognosis in preterm infants with infection (all P<0.05). 【Conclusion】 The levels of serum TLR4, sIL-2R and HLA-B27 have significant value in predicting the prognosis of infection in premature infants, and the combined predictive value of the three is even higher.

Key words： Infant, Premature Infections Toll-Like Receptor 4 Receptors, Interleukin-2 HLA Antigens Prognosis

收稿日期: 2025-12-29

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R722

引用本文:

郭晓鹤, 康莺歌, 张原景. 血清TLR4、sIL-2R联合HLA-B27水平对不同病原菌感染早产儿预后的预测价值[J]. 医学临床研究, 2026, 43(4): 591-594.
GUO Xiaohe, KANG Yingge, ZHANG Yuanjing. Analysis of the Prognostic Value of Serum TLR4, sIL-2R Combined with HLA-B27 Levels in Predicting Infection in Premature Infants. JOURNAL OF CLINICAL RESEARCH, 2026, 43(4): 591-594.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.04.018 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I4/591

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