摘要
目的探讨脓毒症患儿血清趋化因子[CXC趋化因子配体12(CXCL12)及其受体CXC趋化因子受体4(CXCR4)、CC趋化因子配体20(CCL20)及其受体CC趋化因子受体6(CCR6)]与炎症因子和住院期间预后的关系。方法选择2019年2月-2021年6月河北北方学院附属第一医院儿内科收治的309例儿童脓毒症患者(脓毒症组),另选择71名同期于本院体检健康儿童为对照组。收集临床资料,采集静脉血检测血清CXCL12、CXCR4、CCL20、CCR6和炎症因子水平,记录临床结局。多因素logistic回归分析影响脓毒症患儿院内死亡的危险因素。结果脓毒症组血清CXCL12、CXCR4、CCL20、CCR6、降钙素原(PCT)、白细胞介素-6(IL-6)、C反应蛋白(CRP)水平分别为(1.25±0.21)ng/mL、(1.68±0.31)pg/mL、(225.35±36.98)pg/mL、(2.58±0.65)ng/mL、(1.10±0.23)ng/mL、(7.02±2.19)pg/mL、(21.85±6.27)mg/L,均高于对照组的[(0.53±0.16)ng/mL、(0.63±0.18)pg/mL、(36.31±10.49)pg/mL、(0.51±0.13)ng/mL、(0.02±0.01)ng/mL、(4.72±0.58)pg/mL、(5.04±1.52)mg/L],差异均有统计学意义(t=32.094、37.905、77.333、51.664、82.205、16.667、42.056,P均<0.001)。脓毒症患儿血清CXCL12、CXCR4、CCL20、CCR6水平与PCT(r=0.539、0.492、0.503、0.465)、IL-6(r=0.596、0.633、0.571、0.625)、CRP(r=0.456、0.441、0.402、0.417)水平成正相关,差异均有统计学意义(P均<0.05)。309例患儿中共300例追踪到临床结局,根据患儿院内存活情况将其分为死亡组(n=53)和存活组(n=247),死亡组脓毒症休克、机械通气、电解质紊乱、急性肾损伤比例以及急性生理与慢性健康评估Ⅱ(APACHEⅡ)评分、序贯器官衰竭评估(SOFA)评分、尿素氮、血肌酐、血清CXCL12、CXCR4、CCL20、CCR6、PCT、IL-6、CRP水平高于存活组,差异均有统计学意义(P均<0.05)。APACHEⅡ评分、脓毒症休克、PCT、CRP、CXCL12、CXCR4、CCL20、CCR6是影响脓毒症患儿院内死亡的相关因素(OR=2.427、1.206、1.683、2.173、1.142、2.333、2.067、1.079,P�
Objective To investigate the relationships between serum chemokine CXC chemokine ligand 12(CXCL12)and its receptor CXC chemokine receptor 4(CXCR4),CC chemokine ligand 20(CCL20)and its receptor CC chemokine receptor 6(CCR6)with inflammatory factors and prognosis during hospitalization in children with sepsis.Methods A total of 309 children with sepsis(sepsis group)who were treated in the Pediatrics Department of First Affiliated Hospital of Hebei North University from February 2019 to June 2021 were selected,and 71 healthy children who underwent physical examination during the same period in this hospital were selected as control group.Clinical data were collected;venous blood was collected to detect serum levels of CXCL12,CXCR4,CCL20,CCR6 and inflammatory factors,and clinical outcomes were recorded.Multivariate logistic regression was used to analyze the risk factors for hospital death in children with sepsis.Results The levels of serum CXCL12,CXCR4,CCL20,CCR6,procalcitonin(PCT),interleukin-6(IL-6)and C-reactive protein(CRP)in sepsis group were(1.25±0.21)ng/mL,(1.68±0.31)pg/mL,(225.35±36.98)pg/mL,(2.58±0.65)ng/mL,(1.10±0.23)ng/mL,(7.02±2.19)pg/mL and(21.85±6.27)mg/L,respectively,which were higher than those in control group[(0.53±0.16)ng/mL,(0.63±0.18)pg/mL,(36.31±10.49)pg/mL,(0.51±0.13)ng/mL,(0.02±0.01)ng/mL,(4.72±0.58)pg/mL,(5.04±1.52)mg/L],the differences were statistically significant(t=32.094,37.905,77.333,51.664,82.205,16.667,42.056;P all<0.001).The levels of serum CXCL12,CXCR4,CCL20 and CCR6 in children with sepsis were positively correlated with the levels of PCT(r=0.539,0.492,0.503,0.465),IL-6(r=0.596,0.633,0.571,0.625)and CRP(r=0.456,0.441,0.402,0.417);the differences were statistically significant(P all<0.05).A total of 300 out of 309 children were tracked for clinical outcomes,and they were divided into the death group(n=53)and the survival group(n=247).The proportion of septic shock,mechanical ventilation,electrolyte disturbance,acute kidney injury,and acute physiological and chronic he
作者
邢静
王艳飞
闫慧娟
王新梅
刘振奎
XING Jing;WANG Yanfei;YAN Huijuan;WANG Xinmei;LIU Zhenkui(Department of Pediatrics,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《热带医学杂志》
CAS
2023年第6期809-814,共6页
Journal of Tropical Medicine
基金
河北省医学科学研究课题计划(20200503)
