血清IL-6、IL-8、IgM抗体及T细胞亚群水平对新生儿先天性梅毒的诊断价值

目的:探讨血清白介素-6(IL-6)、白介素-8(IL-8)、IgM抗体及T细胞亚群对先天性梅毒新生儿的诊断价值。方法:选择2015年5月至2017年5月在我院进行临床治疗的先天性梅毒新生儿81例为观察组,另选同期来我院进行健康体检81例新生儿为对照组。比较两组患者血清IL-6、IL-8、T细胞亚群中CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+)细胞及IgM抗体的阳性率。结果:治疗后,观察组血清IL-6、IL-8水平均明显高于对照组(P0.05),T细胞亚群中CD~(3+)、CD~(4+)、CD~(4+)/CD~(8+)明显低于对照组,而CD~(8+)T细胞比例高于对照组(P0.05)。19S-IgM-TP ELISA法检测出IgM的阳性率92.59%,明显高于TRUST法(74.07%)及TP-ELSA法(70.37%)(P0.05)。ROC曲线中,血清IL-8特异度为88.34%明显高于血清IL-6特异度81.48%、IgM抗体特异度60.13%、T细胞亚群特异度65.34%;IgM抗体的曲线面积88.91 cm~2明显大于IL-6的曲线面积45.09 cm~2、IL-8的曲线面积76.19 cm~2、T细胞亚群的曲线面积77.35 cm~2;T细胞亚群准备性67.89%明显高于IL-6准确性60.39%、IL-8准确性51.09%、IgM抗体准确性50.12;IgM抗体的灵敏度60.13%高于IL-6灵敏度59.19%、IL-8灵敏度42.35%、T细胞亚群灵敏度59.37%。具有比较意义(P0.05)。结论:血清IL-6、IL-8水平、T细胞亚群中CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+)及IgM抗体阳性率是诊断先天性梅毒新生儿的重要指标。

Diagnostic Value of IL-6 IL-8 IgM Antibody and T Cell Subsets in Congenital Syphilis Neonates

ABSTRACT Objective: To study the diagnostic value of IL-6, IL-8, IgM antibody and T cell subsets for the congenital syphilis neonates. Methods: 81 cases of children with congenital syphilis neonatal in our hospital from May 2015 to May 2017 were selected as the observation group, and 81 cases of healthy newborns were selected as the control group. The percentages of CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ cells, positive rate of IgM and serum IL-6, IL-8 levels were compared between the two groups before and after treatment. Results: After treatment, the levels of serum IL-6 and IL-8 in the observation group were significantly higher than those in the control group (P<0.05), CD3⁺, CD4⁺/CD8⁺T cell subsets were significantly lower than those in the control group (P<0.05). The positive rate of IgM was 92.59%, which was significantly higher than that of TRUST (74.07%) and TP-ELSA (70.37%) (P<0.05) by 19S-IgM-TP ELISA. In the ROC curve, the specificity of serum IL-8 was 88.34%, which was significantly higher than that of serum IL-6 specificity of 81.48%, IgM antibody specificity of 60.13%, T cell subgroup specificity of 65.34%; IgM antibody curve area of 88.91 cm² was significantly larger than The curve area of IL-6 was 45.09 cm², the curve area of IL-8 was 76.19 cm², the curve area of T cell subsets was 77.35 cm², the prepara- tion rate of T cell subsets was 67.89%, which was significantly higher than that of IL-6 60.39% Accuracy of 51.09%, IgM antibody accu- racy of 50.12; IgM antibody sensitivity of 60.13% higher than IL-6 sensitivity of 59.19%, IL-8 sensitivity of 42.35%, T cell subpopulation sensitivity of 59.37%(P<0.05). Conclusion: The percentages of CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ cells, positive rate of IgM and serum IL-6, IL-8 levels were important indexes for the diagnosis of neonatal syphilis.