摘要
目的检测脓毒症致急性肾损伤儿童胱抑素C和炎症因子,并探究其临床意义。方法选择2012年1月至2015年12月在湖北省妇幼保健院诊治的脓毒症致急性肾损伤儿童30例为研究对象（SAKI组）,另选择同期诊断为单纯脓毒症（SEP组）和门诊健康体检的正常健康儿童（CON组）各30例为对照。检测三组研究对象的肾功能、胱抑素C和炎症因子,并对检测结果进行比较,对胱抑素C、炎症因子与急性生理学及慢性健康状况评价（APACHEⅡ）的相关性进行分析。结果 SEP组儿童的肌酐（Scr）、尿素氮（BUN）和胱抑素C与CON组儿童比较差异均无统计学意义（均P〉0.05）,肿瘤坏死因子（TNF）-α和白细胞介素（IL）-6均显著高于CON组儿童（t值分别为25.999、11.966,均P〈0.05）,而IL-10则显著低于CON组儿童（t=7.295,P〈0.05）。SAKI组儿童Scr、BUN、胱抑素C、TNF-α和IL-6均显著高于SEP组和CON组（t值分别为3.300~100.390、3.200~99.800,均P〈0.05）,而IL-10均显著低于SEP组和CON组（t值分别为25.987、18.692,均P〈0.05）。经相关性分析表明,SAKI组儿童的胱抑素C、TNF-α和IL-6与APACHEⅡ评分均呈正相关（rs值分别为0.422、0.369、0.417,均P〈0.05）,IL-10与APACHEⅡ评分呈负相关（rs=-0.381,P〈0.05）;SEP组儿童TNF-α和IL-6与APACHEⅡ评分均呈正相关（rs值分别为0.314、0.372,均P〈0.05）,IL-10与APACHEⅡ评分呈负相关（rs=-0.319,P〈0.05）。结论胱抑素C和炎症因子在脓毒症致急性肾损伤儿童中显著升高,与病情严重程度紧密相关,可作为其病情及预后评估的标志物。
Objective To study the clinical significance of cystatin C and inflammatory factors in children with sepsis induced acute kidney injury（ SAKI）. Methods From January 2012 to December 2015 totally 30 children with SAKI were diagnosed and treated in Hubei Provincial Hospital of Health,and they were selected in research subjects（ SAKI group）. Another 30 cases of simple sepsis（ SEP group）and 30 healthy children（ CON group） were selected as controls. Renal function,cystatin C and inflammatory factors were detected and compared among three groups. The correlation between serum cystatin C and inflammatory factors with APACHE II score was analyzed.Results The Scr,BUN and cystatin C were not significantly different between SEP group and CON group（ all P〈0. 05）,but TNF-α and IL-6 in SEP group were significantly higher than in CON group（ t value was 25. 999 and 11. 966,respectively,both P〈0. 05） while IL-10 was remarkably lower（ t = 7. 295,P〈0. 05）. In SAKI group Scr,BUN,cystatin C,TNF-α and IL-6 were significantly higher than those in SEP group and CON group（ t value ranged 3. 300- 100. 390 and 3. 200- 99. 800,respectively,all P〈0. 05）,but IL-10 was remarkably lower（ t value was 25. 987 and 18. 692,respectively,both P〈0. 05）. Correlation analysis showed that in SAKI group cystatin C,TNF-α and IL-6 were positively correlated with APACHE II score（ rsvalue was 0. 422,0. 369 and 0. 417,respectively,all P〈0. 05）but IL-10 was negatively correlated with APACHE Ⅱ score（ rs=- 0. 381,P〈0. 05）. In SEP group,TNF-α and IL-6 were positively correlated with APACHEⅡ score（ rsvalue was 0. 314 and 0. 372,respectively,both P〈0. 05） but IL-10 was negatively correlated with APACHEⅡscore（ rs=- 0. 319,P〈0. 05）. Conclusion The cystatin C and inflammatory factors in children with sepsis induced acute kidney injury are significantly higher than healthy children,which are closely related with severity of the disease and could act as biomarker for its condition and prognos
出处
《中国妇幼健康研究》
2016年第8期965-967,共3页
Chinese Journal of Woman and Child Health Research
关键词
脓毒症
急性肾损伤
胱抑素C
炎症因子
sepsis
acute kidney injury
cystatin C
inflammatory factor
