신생아 패혈증의 조기진단을 위한 interleukin-6와 C-반응 단백 검사의 유용성

Abstract

Objectives : Neonatal sepsis remains a major cause of mortality in newborn infants. This study was undertaken to seach for parameters with interleukin-6(IL-6) and C-reactive protein(CRP) that could be helpful in the early diagnosis of neonatal sepsis. Methods : Twenty one newborns with sepsis whose duration in the clinical symptoms was less than 24 hours after onset of infection were compared with 20 neonates who were ruled out infection as control. Serum IL-6 were sequentially checked using enzyme immunoassay kit on day 0 and 2. Also, CRP were sequentially checked by nephelometry on day 0, 2 and 10. Results : Between sepsis and control group, demographic characteristics such as gestational age and birth weight were similar distribution. The common pathogens of sepsis in 21 patients were S. aureus(29%) and others such as C. albicans, K. pneumoniae, S. epidermidis, S. agalactiae etc. Level of IL-6 on day 0(150±158pg/mL) was significantly higher than day 2(34±27pg/mL) in the sepsis group(p＜0.005). Also, level of IL-6 on both day 0 and 2 in the sepsis group was significantly higher than the control group(p＜0.001).Level of CRP on day 2(4.2±3.6㎎/dL) was significantly higher than day 0(1.4±1.6㎎/dL) in the sepsis group(p＜0.005). Also, level of CRP on both day 0 and 2 in the sepsis group was significantly higher than the control group(p＜0.005) and level on day 10 was significantly lower with clinical improvement of sepsis than day 2(p＜0.001). IL-6 was superior to CRP on day 0, but CRP was superior to IL-6 on day 2 in the diagnostic validity, and combined use of IL-6 and CRP showed the most sensitivity and negative predictive value. Conclusions : Serum IL-6 value is a sensitive parameter for diagnosis of neonatal sepsis at the early phase. Also, the combination and IL-6 and CRP considers to be a effective method for the early diagnosis.