serum amyloid a, procalcitonin, tumor necrosis factor-, and interleukin-1 levels in neonatal late-onset sepsis血清淀粉样蛋白a、原降钙素、肿瘤坏死因子和interleukin-1水平新生儿晚发性败血症.pdf

Hindawi Publishing Corporation Mediators of Inflammation Volume 2008, Article ID 737141, 7 pages doi:10.1155/2008/737141 Clinical Study Serum Amyloid A, Procalcitonin, Tumor Necrosis Factor-α, and Interleukin-1β Levels in Neonatal Late-Onset Sepsis Birsen Ucar, Bilal Yildiz, M. Arif Aksit, Coskun Yarar, Omer Colak, Yildiz Akbay, and Ertugrul Colak Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, 26480 Eskisehir, Turkey Correspondence should be addressed to Bilal Yildiz, bilalyn@ Received 25 March 2008; Revised 14 August 2008; Accepted 25 August 2008 Recommended by Ariadne Malamitsi-Puchner Background. Sepsis is an important cause of mortality in newborns. However, a single reliable marker is not available for the diagnosis of neonatal late-onset sepsis (NLS). The aim of this study is to evaluate the value of serum amyloid A (SAA) and procalcitonin (PCT) in the diagnosis and follow-up of NLS. Methods. 36 septic and healthy newborns were included in the study. However, SAA, PCT, TNF-α, IL-1β, and CRP were serially measured on days 0, 4, and 8 in the patients and once in the controls. ¨ Tollner’s sepsis score (TSS) was calculated for each patient. Results. CRP, PCT, and TNF-α levels in septic neonates at each study day were significantly higher than in the controls (P = .001). SAA and IL-1β levels did not differ from healthy neonates. The sensitivity and specificity were 86.8% and 97.2% for PCT, 83.3% and 80.6% for TNF-α, 75% and 44.4% for SAA on day 0. Conclusion. Present study suggests that CRP seems to be the most helpful indicator and PCT and TNF-α may be useful markers for the early diagnosis of NLS. However, SAA, IL-1β, and TSS are not reliable markers for the diagnosis and follow-up of NLS. Copyrigh