Journal of Developmental Medicine(Electronic Version)  2024, Vol. 12 Issue (5): 342-349 DOI: 10.3969/j.issn.2095-5340.2024.05.004 |
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| Predictive value of RIP3, nCD11b and PCT dynamic changes in neonatal sepsis |
| Feng Xiaoyun, Cai Qinwu, Wang Changle, et al
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1. Department of Pediatrics, WanningPeople's Hospital of Hainan Province, Hainan, Wanning 571500, China; 2. Department of Neonatology,Wanning People's Hospital of Hainan Province, Hainan, Wanning 571500, China
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Abstract 【Abstract】 Objective To explore the dynamic changes and significance of receptor interacting protein
3 (RIP3), antigen cluster differentiation molecule 11b (nCD11b), and procalcitonin (PCT) in the treatment
of neonatal sepsis. Method A prospective study was conducted on 80 neonates with sepsis admitted
to Wanning People's Hospital of Hainan Province from September 2020 to October 2022, they were
divided into effective group (n=56) and ineffective group (n=24) according to the different efficacy. The
baseline data, the levels of RIP3, nCD11b, PCT, white blood cell count (WBC), and C-reactive protein (CRP) at pre-treatment, 24-hour post-treatment, and 72-hour post-treatment were compared between the two groups. The statistical methods performed by t-test, χ2 test, repeated measure ANOVA, Spearman method, Logistic regression analysis, receiver operating characteristic (ROC) curve analysis and clinical decision analysis (CDA). Result RIP3 in the effective group was lower than that in the ineffective group after 24 h and 72 h treatment [24 h: (18.5±5.0) μg/Lvs (22.8±7.6) μg/L, 72 h: (13.6±3.2) μg/L vs (21.8±6.9) μg/L, Fbetween groups=9.102, all P<0.05]. nCD11b in the effective group was lower than that in the ineffective group after 24 h and 72 h treatment [24 h: (2.5±0.8)% vs (3.8±1.2)%, 72 h:(1.6±0.5)% vs (3.7±1.2) %, Fbetween groups=8.596, all P<0.05]. The PCT in the effective group was lower than that in the ineffective group after 24 h and 72 h treatment [24 h: (4.5±1.3) μg/L vs
(5.2±1.1) μg/L, 72 h: (1.3±0.4) μg/L vs (5.1±1.2) μg/L, F=13.841, all P<0.001]. The CRP in the effective
group was lower than that in the ineffective group after 24 h and 72 h treatment [24 h: (22.2±7.2) mg/L vs (25.7±8.1) mg/L, 72 h: (20.2±6.7) mg/L vs (24.6±6.8) mg/L, Fbetween groups=10.869, all P<0.001]. Logistic regression analysis showed that RIP3, nCD11b, PCT, and CRP were all independent factors related to the efficacy of neonatal sepsis after 72 h treatment (OR values were 4.163, 4.469, 6.337, and 3.128, respectively, all P<0.001). Spearman correlation analysis showed that the indicators were more strongly correlated with the efficacy after 72 h treatment (r values were larger), and the r values of RIP3, nCD11b, and PCT were greater than CRP, indicating a stronger correlation with the efficacy. ROC curve analysis showed that the area under the curve (AUC) of RIP3+nCD11b+PCT combined detection after 72 h treatment was the largest(0.939), with a predictive sensitivity of 87.50% and a specificity of 87.50% (P<0.001). The DCA curve analysis showed that RIP3+nCD11b+PCT combined detection after 72 h treatment for efficacy prediction had clinical net benefits. Conclusion The dynamic changes of RIP3, nCD11b, and PCT during the treatment of neonatal sepsis are related to the therapeutic response of the children, and their correlation is stronger than that of conventional CRP. The combined detection of RIP3, nCD11b, and PCT after 72 h treatment has high predictive value and good clinical utility for non-response to treatment, and is expected to become a marker for guiding medication.
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Received: 12 June 2023
Published: 30 September 2024
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