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

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (3): 262-264.doi: 10.3969/j.issn.1674-3865.2017.03.025

• 临床研究 • 上一篇    下一篇

肿瘤坏死因子α和白细胞介素2水平在脓毒症患儿心肌早期损伤中的预测作用

朱德胜，罗兰，曾方玲   

  1. 410007 长沙，湖南省儿童医院急救中心
  • 出版日期:2017-06-25 发布日期:2017-12-08
  • 通讯作者: 朱德胜，E-mail：2301683192@qq.com
  • 作者简介:朱德胜（1982-），男，医学硕士，主治医师。研究方向：小儿危重症的诊治

Predictive value of IL-2 and TNF-α levels in early myocardial injury in children with sepsis

ZHU Desheng，LUO Lan，ZENG Fangling   

  1. Hunan Children's Hospital Emergency Center，Changsha 410007，China
  • Online:2017-06-25 Published:2017-12-08

PDF (PC)

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摘要：
目的
探究肿瘤坏死因子α（TNF-α）和白细胞介素2（IL-2）水平在脓毒症患儿心肌早期损伤中的预测作用。
方法
2016年1月至6月湖南省儿童医院重症医学二科收治住院的脓毒症患儿64例，为脓毒症组，另选取同期住院的普通感染患儿64例为普通感染组，选取同期健康体检儿童64例为正常对照组。通过Elisa法和免疫化学发光法分别检测TNF-α和IL-2水平，并观察比较脓毒症患儿经治疗12 h、24 h及48 h后二者水平的变化；超声心动图检测脓毒症患儿心功能指标（包括左房内径、左室射血分数、左室舒张末压），分析脓毒症患儿血清TNF-α和IL-2水平和心功能指标变化的关系。
结果
3组儿童血清TNF-α与IL-2水平比较差异均有统计学意义（P<0.05）。进一步两两比较，脓毒症组患儿血清TNF-α与IL-2水平均显著高于普通感染组和正常对照组，普通感染组又显著高于正常对照组，差异均有统计学意义（P<0.05）。随着治疗时间的延长，经48 h治疗后脓毒症患儿血清TNF-α与IL-2水平显著低于治疗12 h和24 h，治疗后24 h显著低于治疗12 h，差异有统计学意义（P<0.05）。相关分析显示，血清TNF-α和IL-2均与脓毒症患儿左房内径、左室舒张末压呈正向相关，而与左室射血分数呈负向相关（P<0.05）。
结论
脓毒症患儿存在显著的血清TNF-α与IL-2高水平，并与治疗时间、心功能损伤的程度关系密切，对患儿预后的判断具有重要的意义。

关键词: 脓毒症, 心肌早期损伤, TNF-α, IL-2, 儿童

Abstract:
Objective
To explore the predictive value of TNF-α and IL-2 levels in early myocardial injury in children with sepsis.
Methods
A total of 64 cases of children with sepsis admitted to General Ⅱ Emergency Department of our hospital from January 2016 to June 2016 were randomly selected as the treatment group. Another 64 cases of routinely infected children were chosen as the observation group; meanwhile, 64 cases of normal children were included as the control group. The levels of IL-2 and TNF-α in the three groups were detected by means of Elisa and chemiluminescence immunoassay, respectively, and the changes of the two levels at 12 hours, 24 hours and 48 hours after treatment were observed and compared. The cardiac function indexes (including LAD, LVEF, LVEDP) in the three groups were detected through echocardiography. The relationship between serum levels of TNF-α and IL-2 and the changes of cardiac function in children with sepsis was analyzed.
Results
There were significant differences in serum levels of TNF-α and IL-2 among the three groups (P<0.05). After a further comparison, the serum levels of TNF-α and IL-2 in treatment group were significantly higher than those of the observation group and control group, and the observation group was significantly higher than the control group, the differences being statistically significant (P<0.05). As the treatment time increased, the serum levels of TNF-α and IL-2 in treatment group were significantly lower at 48h than those at 12h and 24h after treatment, and the levels at 24h after treatment was significantly lower than that at 12h after treatment, the difference being statistically significant(P<0.05). Correlation analysis showed that serum TNF-α and IL-2 were positively correlated with LAD and LVEDP in children with sepsis, but negatively correlated with LVEF(P<0.05).
Conclusion
The serum levels of TNF-α and IL-2 in children with sepsis are obviously higher and they are closely related to the treatment time, as well as the degree of cardiac function injury, which is of great importance to judging the prognosis of the patients.

Key words: Sepsis, Early myocardial injury, TNF-α, IL-2, Child