摘要
目的了解降钙素原(PCT)在全身炎症反应综合征(SIRS)发病中的变化及其与病情危重程度的关系;探讨PCT的生物学机制及在SIRS发病中的作用。方法选择2004-01—2004-12河北医科大学第四医院儿科SIRS患儿60例,依据SIRS诊断评分标准分为:S2组21例、S3组22例、S4组17例。并将此60例依据简化PCIS评分分为3组:非危重组54例、危重组4例、极危重组2例。并选择同期健康体检儿童20例,作为对照组。采用免疫化学发光法、酶联免疫吸附法(ELISA)检测患儿血清PCT、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)及白介素-10(IL-10)的质量浓度。结果SIRS患儿急性期血清PCT质量浓度[(0·57±0·35)ng/mL]明显高于对照组[(0·18±0·17)ng/mL](P<0·01)。细菌感染组血清PCT质量浓度[(0·73±0·37)ng/mL]明显高于病毒感染组[(0·37±0·21)ng/mL]及非感染性疾病组[(0·43±0·28)ng/mL](P<0·05)。SIRS评分与血清PCT水平变化:S4组PCT质量浓度[(0·73±0·49)ng/mL]明显高于S2组[(0·46±0·27)ng/mL](P<0·05),S2组与S3组,S3组与S4组比较,差异均无显著性意义(P>0·05)。SIRS患儿血清PCT质量浓度与简化PCIS评分呈显著负相关(r=-0·306,P<0·05)。血清PCT水平与TNF-α、IL-10水平呈显著正相关(r值分别为0·259和0·268,均P<0·05);与IL-1β无显著相关性(r=0·029,P>0·05)。结论PCT有助于诊断、判断病情及鉴别不同病因所致SIRS。PCT水平的高低可反映病情的危重状态。PCT作为一种炎症介质参与SIRS的病理过程,并在SIRS的发生发展进程中和致炎因子与抑炎因子相互促进、相互拮抗,参与炎症反应。
Objective To explore the changes of PCT in SIRS and the relationship between PCT and children＇s condition;to explore the biological mechanisms of PCT and the role in the pathogenesis of SIRS. Methods Totally 60 children with SIRS from March 2004 .to ,December 2004 were randomly selected. Based on SIRS score, they were divided into three groups：21 cases in S2 group （.accord with 2 items of score） ,22 cases in S3 group（ accord with 3 items） and 17 cases in S4 group（accord with 4 items ）. According to Pediatric Critical Illness Scoring（ PCIS ）all the children were divided into three groups：54 cases in non-serious group （score 64 -80） ,4 cases in serious group （score 56 -64） and 2 cases in very serious group（ score 〈 56 ）. The serum levels of PCT,TNF-α,IL-1β and IL-10 in children with SIRS were tested by enzyme-linked immunoadsorbent, assay（ ELISA ） and immunochemiluminescent. Results The serum level of PCT （ 0. 57 ± 0. 35ng/mL） in children with acute SIRS was significantly higher than that 1 0. 18 ± 0. 17 ng/mL ）in the control group （ P 〈 0. 01 ）. The serum level of PCT in children with bacterial infection（0. 73 ± 0. 37 ng/mL ） was significantly higher than that in children with virus infection（0. 37 ±0. 21ng/mL） and the non- infectious（0. 43 ±0. 28ng/mL） （ P 〈0. 05 ）. Observe the changes between the serum level of PCT and SIRS score： the serum level of PCT in S4 group （ 0. 73 ± 0. 49ng/ mL） was significantly higher than that in S2 group （0. 46 ± 0. 27ng/mL） （ P 〈 0. 05）. The serum level of PCT in S3 group （0. 56 ±0. 26ng/mL） was higher than that in S2 group whereas lower than that in S4 group,but there was no statisically significant difference （ P 〉 0. 05 ）. There was significant negative correlation between the serum level of PCT in children with SIRS and the PCIS score（r = -0.306, P 〈0.05）.There was significant positive correlation between serum level of PCT and TNF-α or IL-10 （ r = 0. 259 and r = 0
出处
《中国实用儿科杂志》
CSCD
北大核心
2007年第8期595-598,共4页
Chinese Journal of Practical Pediatrics
