摘要
目的探讨可溶性晚期糖基化终末产物受体(soluble receptor for advanced glycation end products,sRAGE)在小儿脓毒症严重程度及预后评价中的价值。方法选取108例脓毒症患儿,分为脓毒症组(n=65)、严重脓毒症组(n=26)及脓毒性休克组(n=17);选取30例健康儿童为正常组。比较各组血浆sRAGE和第三代小儿死亡危险(pediatric risk of mortalityⅢ,PRISM III)评分。分析血浆sRASE水平在小儿脓毒症严重程度及预后评价中的价值。结果脓毒症组、严重脓毒症组及脓毒性休克组患儿sRAGE水平均显著高于正常组(P<0.05)。随着脓毒症严重程度的增加,患儿血浆sRAGE水平及PRISM III评分显著增高(P<0.05)。脓毒症患儿血浆sRAGE水平与PRISM III评分存在正相关(r=0.302,P=0.016)。死亡组患儿血浆sRAGE水平显著高于存活组(P<0.05)。血浆sRAGE预测严重脓毒症/脓毒性休克的最佳阈值为827.0pg/mL,AUC=0.759(95%CI 0.579~0.938,SE=0.091,P=0.0033),灵敏度为0.512,特异性为0.923。血浆sRAGE预测脓毒症患儿死亡的最佳阈值为845.0pg/mL,AUC=0.801(95%CI 0.624~0.978,SE=0.090,P=0.0013),灵敏度为71.4%,特异性为89.7%。结论脓毒症患儿血浆sRAGE水平明显增高,且其水平与病情危重程度及预后相关。
Objective To evaluate the value of soluble receptor for advanced glycation end products （sRAGE） in evaluating the severity and prognosis of children＇s sepsis. Methods 108 children with sepsis were selected and divided into four groups including the sepsis group （n= 65）, severe sepsis grnup （n~ 26）, septic shock group （n= 17） and normal group （n=30）. Plasma sRAGE and pediatric risk of mortality Ill （PRISM lid were evaluated and compared among the four groups to analyze the potential value of plasma sRAGE in evaluating the severity and prognosis of childrenrs sepsis. Results The plasma sRAGE levels in the sepsis group, severe sepsis group and septic shock group were significantly higher than that in the normal group respectively （P〈0. 05）. The level of plasma sRAGE and the score of PRISM III increased with the increase of sepsis severity （P〈0. 05）, and there was a positive correlation between the level of plasma sRAGE and the score of PRISM III （r= 0. 302, P 〈 0. 016）. The level nf plasma sRAGE in the death group were significantly higher than that in the survival group （P〈0. 05）. The best threshold value of plasma sRAGE in predicting sepsis/septic shock was 827.0 pg/mL, the AUC value was 0. 759 （95 ~ CI 0. 579 ~ 0. 938, SE= 0. 091, P = 0. 0033）, the sensitivity was 0. 512, and the specificity was 0. 923. The best threshold value of plasma sRAGE in predicting the sepsis prognosis was 845.0 pg/mL, the AUC value was 0. 801 （95%CI 0. 624~0. 978, SE=0. 090, P=0. 0013）, the sensitivity was 71.4%, and the specificity was 89.7 M. Conclusion The level of plasma sRAGE in the children with sepsis is obviously increased and correlated with the severity and prognosis of sepsis respectively.
出处
《成都医学院学报》
CAS
2017年第4期457-460,共4页
Journal of Chengdu Medical College
基金
国家卫生和计划生育委员会公益性行业科研专项项目(No:201302003)
四川省卫生和计划生育委员会科研课题(No:16PJ305)
成都市科技惠民计划项目(No:2016-HM02-00099-SF)
关键词
脓毒症
儿童
可溶性晚期糖基化终末产物受体
预后
Sepsis
Children
Soluble receptor for advanced glycation end products
Prognosis
