신생아 패혈증 환아에서 혈청 Tumor Necrosis Factor-Alpha(TNF-α)수치의 변화

Abstract

Sepsis is a major cause of morbidity and mortality during the neonatal period, especially in premature infant. To evaluate the predictive value of serum tumor necrosis factor-alpha(TNF-α) level in neonatal sepsis, the authors obtained serum and cheked the TNF-α level at admission(or diagnosis), 1, 2 and 3 weeks after diagnosis respectively on 26 neonates who had symptoms of sepsis and were admitted at the NICU of the department of Pediatrics, Dong-San Hospital, Keimyung University during a period of 1 year from June 1993 to May 1994. According to the gestational age and the result of the blood culture, they were divided into 3 groups, a control group which did not have sepsis, group Ⅰ which had sepsis in fullterm babies, and group Ⅱ which had sepsis in premature babies. The following results were obtained. 1. At Diagnosis, serum TNF-α level was significantly higher(p＜0.05) in group Ⅰ (238.2±234.6 pg/㎖) than in the control(9.1±24.0 pg/㎖) and group Ⅱ(9.0±17.8 pg/㎖). And during 1-3 weeks after diagnosis, serum TNF-α level was significantly higher(p＜0.05) in group Ⅰ and group Ⅱ than in the control group. 2. During 1-3 weeks after diagnosis, serum TNF-α levels were similar between group Ⅰ and group Ⅱ. 3. The sensitivity and specificity of increased serum TNF-α level(＞15 pg/㎖) as an index of sepsis were 80%, 87.5% in fullterm(p＜0.005), and 12.5%, 100% in premature(p＞0.1) groups at diagnosis. And those were 70 %, 100 % in fullterm(p＜0.005), and 62.5 %, 100 % in premature(p＜0.05) groups at 1 week after diagnosis respectively. 4. The mean serum TNF-α levels were similar between gram(+) and (-)sepsis.