| Objective: To investigate the clinical value of serum neutrophil to monocyte ratio (NMR), 25 hydroxyvitamin D (VitD) levels, and vitamin D receptor (VDR) gene polymorphism in diagnozing neonatal sepsis. Methods: Retrospective analysis of clinical data from neonates with sepsis admitted to our neonatal intensive care unit from October 2022 to October 2024. Eighty neonates with positive blood cultures were assigned to the positive group, and 80 neonates with clinical symptoms but negative blood cultures were assigned to the negative group. Fifty healthy neonates from the same period served as controls. NMR and VitD levels were measured before and 14 days after antibiotic treatment, with comparisons among the three groups. PCR sequencing was used to analyze VDR gene polymorphism sites (rs2228570, rs757343, rs739837) and compare their expression across groups. Results: Before treatment, the positive and negative groups showed significantly higher NMR and lower VitD levels compared to the control group (P < 0.05). After treatment, NMR decreased and VitD increased significantly in both sepsis groups (P < 0.05). Compared with control group, there were significant differences in the genotype (CC, CT, TT) and allele frequency distribution of rs757343 C>T in observation group 1 and observation group 2(P<0.05), while there was no difference between observation group 1 and observation group 2 (P>0.05). ROC showed that AUC for diagnozing neonatal sepsis by combining pre-treatment NMR, VitD, and allele T was 0.896 (95% CI=0.801~0.955, P<0.001), significantly higher than that of single indicator. Conclusion: Early detection of NMR, VitD, and VDR gene polymorphisms may have important value in diagnozing neonatal sepsis, but it is currently not effective in distinguishing sepsis with positive or negative blood cultures. |
