The diagnostic and prognostic value of peripheral blood CIRP and CXCL5 levels in neonatal sepsis

Li Jia; Yu De-min; Yi Dan; Zhang Linjuan

doi:10.3969/j.issn.1671-6450.2026.02.016

Abstract：Objective To investigate the value of peripheral blood cold-inducible RNA binding protein(CIRP)and CXC chemokine ligand 5(CXCL5)in the diagnosis and prognosis of neonatal sepsis.Methods A total of 113 children with neonatal sepsis admitted to the Department of Pediatrics,Chengdu Xiqu Hospital from June 2021 to June 2024 were selected as the case group.According to the pediatric critical illness score,they were divided into non-critical subgroup(n=51),critical subgroup(n=37),and extremely critical subgroup(n=25).Based on outcome,they were divided into good prognosis subgroup(n=79)and poor prognosis subgroup(n=34).According to a 1∶1 ratio,113 healthy newborns were randomly select-ed as the healthy control group.Serum CIRP and CXCL5 were detected by enzyme-linked immunosorbent assay.Spearman rank correlation analysis was used to analyze their correlation with disease severity.Logistic regression analysis was used to examine their correlation with poor prognosis in children with neonatal sepsis.Receiver operating characteristic(ROC)curve analysis was used to evaluate their diagnostic value and predictive efficacy for poor prognosis in neonatal sepsis.Results Compared with the healthy control group,the serum levels of CIRP and CXCL5 in the case group were increased(t/P=18.223/＜0.001,26.819/＜0.001).With the aggravation of neonatal sepsis,the levels of serum CIRP and CXCL5 gradually in-creased(F/P=77.582/＜0.001,177.616/＜0.001).Serum CIRP and CXCL5 were positively correlated with disease severity(rs=0.682,0.703,both P＜0.001).Compared with the good prognosis subgroup,the poor prognosis subgroup had more severe dis-ease,and the levels of serum CIRP and CXCL5 were increased(t/P=5.504/＜0.001,8.546/＜0.001).Disease severity being criti-cal or extremely critical[compared with non-critical children,the risk of poor prognosis increased by 2.807 times and 10.859 times,respectively(P＜0.05)],and elevated serum CIRP and CXCL5 were independent risk factors for poor prognosis in chil-dren with neonatal sepsis[OR(95％CI)=1.756(1.246-2.471),2.046(1.372-3.052)].The AUC values of serum CIRP,CXCL5,and their combination for the diagnosis of neonatal sepsis were 0.803,0.812,and 0.905,respectively.The AUC of the combination was greater than that of each single index(Z=2.215,2.079;P=0.013,0.009).The AUC values of serum CIRP,CXCL5,and their combination for predicting poor prognosis in neonatal sepsis were 0.764,0.758,and 0.887,respectively.The AUC of the combination was greater than that of each single index(Z=1.934,1.891;P=0.022,0.023).Conclusion Peripher-al blood CIRP and CXCL5 levels are elevated in children with neonatal sepsis and are related to disease severity and poor prognosis.Early combined detection can serve as a biomarker for auxiliary diagnosis of neonatal sepsis and prediction of poor prognosis risk.