脓毒症患儿血浆炎性因子的表达水平
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摘要
目的分析脓毒症患儿血浆炎性因子的表达水平。方法检测64例脓毒症患儿(脓毒症组)和30例非感染患儿(对照组)入院时血浆炎性因子水平。脓毒症患儿分为新生儿组(≤28 d)、婴儿组(29 d～1岁)和儿童组(>1岁),比较不同年龄患儿血浆炎性因子水平。结果与对照组相比,脓毒症组血浆IL-6、IL-10、WBC、中性粒细胞百分比和超敏C反应蛋白均升高(P<0.01)。婴儿组及儿童组血浆TNF-α水平较新生儿组高(P<0.01)。64例脓毒症患儿中,5例死亡,死亡患儿入院时IL-6、IL-1β和TNF-α水平均较非死亡患儿升高(P<0.05)。结论脓毒症患儿血浆炎性因子水平升高,可能与疾病的严重程度及预后有关。
Objective To analyze the expression of plasma inflammatory factors in the children with sepsis.Methods Plasma levels of inflammatory factors were detected in the children with sepsis(group A,64 cases) and those without(group B,30 cases).The children of group A were subdivided into groups of A1(age≤28 days),A2(aged 29 days to 1 year) and A3(age>1 year) and plasma levels of inflammatory factors were compared among groups of A1,A2 and A3.Results Compared with group B,plasma levels of IL-6,IL-10,WBC,percentage of neutrophils and high sensitive C-reactive protein were higher in group A(P<0.01).Plasma level of TNF-α was higher in groups of A2 and A3 than that in group A1(P<0.01).Of 64 septic children,5 cases were dead and their plasma levels of IL-6,IL-1β and TNF-α were higher than those in survival children(P<0.05).Conclusion Plasma levels of inflammatory factors are increased in the children with sepsis,which may be related to the severity of the disease and prognosis.
Objective To analyze the expression of plasma inflammatory factors in the children with sepsis.Methods Plasma levels of inflammatory factors were detected in the children with sepsis(group A,64 cases) and those without(group B,30 cases).The children of group A were subdivided into groups of A1(age≤28 days),A2(aged 29 days to 1 year) and A3(age>1 year) and plasma levels of inflammatory factors were compared among groups of A1,A2 and A3.Results Compared with group B,plasma levels of IL-6,IL-10,WBC,percentage of neutrophils and high sensitive C-reactive protein were higher in group A(P<0.01).Plasma level of TNF-α was higher in groups of A2 and A3 than that in group A1(P<0.01).Of 64 septic children,5 cases were dead and their plasma levels of IL-6,IL-1β and TNF-α were higher than those in survival children(P<0.05).Conclusion Plasma levels of inflammatory factors are increased in the children with sepsis,which may be related to the severity of the disease and prognosis.
引文
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[3] Goldstein B,Giroir B,Randolph A.International pediatric sepsis consensus conference:definitions for sepsis and organ dysfunction in pediatrics[J].Pediatr Crit Care Med,2005,6(1):2-8.
[4] Gotts JE,Matthay MA.Sepsis:pathophysiology and clinical management[J].BMJ,2016,353:i1585.
[5] Christaki E,Anyfanti P,Opal SM.Immunomodulatory therapy for sepsis:an update[J].Expert Rev Anti Infect Ther,2011,9(11):1013-1033.
[6] Giamarellos-Bourboulis EJ,Raftogiannis M.The immune response to severe bacterial infections:consequences for therapy[J].Expert Rev Anti Infect Ther,2012,10(3):369-380.
[7] Damas P,Ledoux D,Nys M,et al.Cytokine serum level during severe sepsis in human IL-6 as a marker of severity[J].Ann Surg,1992,215(4):356-362.
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[9] Reinhart K,Meisner M,Brunkhorst FM.Markers for sepsis diagnosis:what is useful[J]?Crit Care Clin,2006,22(3):503-519.
[10] Harbarth S,Holeckova K,Froidevaux C,et al.Diagnostic value of procalcitonin,interleukin-6,and interleukin-8 in critically ill patients admitted with suspected sepsis[J].Am J Respir Crit Care Med,2001,164(3):396-402.
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[12] 辛毅.循环游离DNA与脓毒症患儿免疫炎性机制相关性及预后预测价值的研究[D].山东:山东大学,2017:79-85.
[13] 吴扬,朱玲,林广裕,等.早期综合加强治疗策略抢救小儿脓毒症器官功能不全的临床研究[J].中国实用医药,2010,5(1):1-4.