关键词: 细菌性败血症, 可溶性白细胞分化抗原40配体, 膜联蛋白A1, T细胞免疫球蛋白及粘蛋白域蛋白-4

Abstract: Objective To investigate the expression and clinical significance of soluble cluster of differentiation 40 ligand (sCD40L),annexin A1 (ANXA1),T-cell immunoglobulin and mucin domain-containing protein 4 (TIM-4) in the serum of neonates with bacterial sepsis. Methods From September 2022 to March 2024,122 neonates with bacterial sepsis admitted to Shijiazhuang Fifth Hospital were included as the sepsis group, 122 newborns with common bacterial infection were selected as the infection group and 122 healthy newborns were selected as the control group. The level of sCD40L, ANXA1, and TIM-4 in serum was compared; multivariate logistic regression was used to analyze the influencing factors of bacterial sepsis; Receiver operating characteristic curve (ROC) curve was used to analyze the diagnostic value of serum sCD40L, ANXA1, and TIM-4 levels for bacterial sepsis. Results Compared with control group, the level of serum sCD40L,ANXA1 and TIM-4 was significantly higher in the sepsis group and infection group (P＜0.05); the level of serum sCD40L,ANXA1 and TIM-4 were obviously higher in the sepsis group (P＜0.05); The white blood cell count, CRP and SOFA scores of children in the sepsis group and infection group were all significantly higher (P＜0.05). Compared with the infection group, the white blood cell count, C-reactive protein(CRP)and Sequential Organ Failure Assessment(SOFA) scores of the sepsis group were obviously higher (P＜0.05). CRP,SOFA score,sCD40L,ANXA1,and TIM-4 were all influencing factors of bacterial sepsis (P＜0.05). The area under the curve (AUC) of serum sCD40L, ANXA1, and TIM-4 level for diagnosing bacterial sepsis was 0.744, 0.797, and 0.827, respectively. The AUC of the combined diagnosis of the three factors was 0.921,which was obviously higher than that of the single indicator diagnosis (Z_{three factors combination-sCD40L}=5.518,Z_{three factors combination-ANXA1}=4.389,Z_{three factors combination-TIM-4}=3.674,P＜0.001,0.001,0.001),the sensitivity of the combined diagnosis of the three was 87.70%,and the specificity was 79.51%. Conclusions The expression level of serum sCD40L, ANXA1, and TIM-4 in children with bacterial sepsis is obviously up-regulated and they are all influencing factors of bacterial sepsis. The combination of the three(triple detection) has high diagnostic value for bacterial sepsis.

Key words: bacterial sepsis, soluble cluster of differentiation 40 ligand, annexin A1, T-cell immunoglobulin and mucin domain-containing protein 4