ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (1): 23-27.doi: 10.3969/j.issn.1674-3865.2019.01.007

• 临床论著 • 上一篇    下一篇

脓毒症患儿病情与血管内皮细胞功能障碍的相关性分析

莫连芹,汪娟,黄栋,王予川   

  1. 550002 贵阳,贵州省人民医院儿科重症监护室(莫连芹,黄栋,王予川);071000 河北 保定,河北大学附属医院儿科(汪娟)
  • 出版日期:2019-02-25 发布日期:2019-07-11
  • 通讯作者: 黄栋,E-mail:hd522523@163.com
  • 作者简介:莫连芹(1989-),女,医学硕士,医师。研究方向:小儿重症的救治
  • 基金资助:
    贵州省科教青年英才培养工程基金项目(黔省专合字LS[2012]184)

Analysis of correlation between the condition of children with sepsis and vascular endothelial dysfunction

MO Lianqin,WANG Juan, HUANG Dong, WANG Yuchuan   

  1. Pediatric Intensive Care Unit,Guizhou People's Hospital,Guiyang 550002,China
  • Online:2019-02-25 Published:2019-07-11

摘要:
目的
探讨脓毒症患儿病情与血管内皮细胞功能障碍的相关性。
方法
选择2017年5月至2018年1月在贵州省人民医院PICU及小儿外科入住24 h以上的脓毒症患儿68例为研究对象,根据患儿病情严重程度分为脓毒症组41例和脓毒性休克组27例;同期选择门诊健康体检者39例作为对照组。根据患儿预后分为存活组53例和死亡组15例;检测炎症指标[血白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)]和内皮细胞损伤标志物[血浆内皮素1(ET-1)、血管性血友病因子(vWF)、可溶性血栓调节蛋白(sTM)]水平,分析组间炎症指标与内皮损伤标志物之间的相关性。
结果
(1)随着脓毒症病情加重,CRP、IL-6、PCT、vWF、sTM、ET-1水平逐渐升高,组间两两比较差异均有统计学意义(P<0.05);(2)脓毒症患儿死亡组与存活组间比较差异有统计学意义(P<0.05),具体表现为WBC在死亡组明显低于存活组,且与脓毒症患儿预后呈正相关。而vWF、sTM、ET1在死亡组均明显高于存活组,且与脓毒症患儿预后呈显著负相关。
结论
脓毒症患儿病情、预后与血管内皮损伤密切相关。

关键词: 脓毒症, 内皮细胞损伤标志物, 相关性, 儿童

Abstract:
Objective
To investigate the relationship between the condition of children with sepsis and vascular endothelial cell dysfunction.
Methods
A total of 68 children with sepsis, who were admitted to the PICU of Guizhou People's Hospital from January 2017 to January 2018 and stayed in the Pediatric Surgery for more than 24 hours ,were selected as subjects. According to the severity of the disease, 41 patients were included in sepsis group and 27 patients in septic shock group. At the same time, 39 outpatients with healthy physical examination were selected as the control group. According to the prognosis of the children, there were 53 patients in the survival group and 15 patients in the death group. Detect the levels of inflammation indicators [white blood cell count(WBC), C-reactive protein(CRP), interleukin-6(IL-6), procalcitonin(PCT)] and endothelial cell injury markers[plasma endothelin 1(ET1),von Willebrand factor(vWF) and soluble thrombomodulin(sTM)]. The correlation between inflammation markers and endothelial injury markers was analyzed.
Results
(1) The levels of CRP, IL-6, PCT, vWF, sTM and ET-1 gradually increased with the increasing severity of sepsis, and the differences between the two groups were statistically significant(P<0.05).(2) There was significant difference between the death group and the survival group(P<0.05). The WBC was significantly lower in the death group than in the survival group, and it was positively correlated with the prognosis of children with sepsis. The vWF, sTM and ET-1 were significantly higher in the death group than in the survival group, and were significantly negatively correlated with the prognosis of children with sepsis.
ConclusionThe condition and prognosis of children with sepsis are closely related to vascular endothelial injury.

Key words: Sepsis, Markers of endothelial cell injury, Correlation, Children