Діагностична цінність гострофазових показників інфекційно-запального процесу у діагностиці раннього неонатального сепсису

Abstract

The objective. The purpose of the study was to examine the diagnostic value of content of C-reactive protein, interleukin 6 and 8 in the blood serum of newborns on the second day of life when they contain factors of susceptibility to infectious-inflammatory process. Patients and methods. We carried out a comprehensive clinical and laboratory examination of 100 newborns in the first two days of their life. The findings were analyzed by means of the methods of biostatistics using the principles of clinical epidemiology. Results. The complex of the conducted clinical studies did not reveal any specific and, moreover, pathognomonic manifestations of infectious and inflammatory diseases on the first and second days of life. Paraclinical studies conducted to determine the rate of proinflammatory cytokines 6 and 8 showed that the examined newborns had predominately low concentrations of these interleukins which do not have sufficient independent diagnostic value to detect early neonatal infection. Determining the rate of C-reactive protein in serum showed that in most children its concentration was more than 10.0 mg/l, but this diagnostic test had a high specificity in targeting it at quite a high concentration. Depending on the point of division, we evaluated the diagnostic value of acute phase indices of inflammation in the confirmation of early neonatal infection. It was established that high rates were specific but not sensitive markers of infectious inflammation process in the acute period of adaptation in infants and were accompanied by pseudo-negative results within 59-79%. The evaluation of the diagnostic value of low results of acute phase indices of inflammation in denial of neonatal infection was accompanied by pseudo- positive results in 42-68% of cases. Соnclusion. Therefore, none of the studied clinical-paraclinical indices can be informative enough and they are diagnostically insignificant in verification of systemic bacterial infection in newborns on the first two days of their life.