摘要
目的探讨小剂量糖皮质激素对小儿脓毒症血清可溶性髓系细胞触发受体1(s TREM-1)、降钙素原(PCT)、CD_(64)的影响。方法选取66例脓毒症患儿,依据随机数字表法分成2组各33例。对照组予原发病和(退热等)对症治疗,予以脓毒症集束化(抗生素、强化胰岛素、营养支持等)治疗,研究组在上述基础上再予小剂量注射用甲泼尼龙琥珀酸钠静点,治疗7 d。检测外周血T淋巴细胞、炎性指标(PCT、CRP、IL-8)和sTREM-1、sICAM-1及sVCAM-1水平。评估PCIS及APACHEⅡ评分,比较治疗效果。结果与治疗前比较,2组CD_3^+、CD_4^+及CD_8^+显著升高(P<0.01),CD_(64)+降低(P<0.01),PCT、CRP、IL-8显著降低(P<0.01),sTREM-1、sICAM-1、sVCAM-1显著降低(P<0.01),PCIS评分显著升高(P<0.05),APACHEⅡ评分显著降低(P<0.05);与对照组比较,研究组CD_3^+、CD_4^+及CD_8^+显著较高(P<0.01),CD_(64)+显著较低(P<0.01),PCT、CRP、IL-8显著较低(P<0.01),sTREM-1、sICAM-1、sVCAM-1显著较低(P<0.01),PCIS评分显著较高(P<0.05),APACHEⅡ评分显著较低(P<0.05),总有效率显著较高(P<0.05)。结论小剂量糖皮质激素能有效降低脓毒症患儿血清sTREM-1、PCT、CD_(64)^+水平。
Objective To investigate the effect of low-dose hormone on serum soluble triggering receptor expressed on myeloid cells-1 （TREM-1）, procalcitonin（PCT） and CD64 in children with sepsis. Methods Sixty-six children with sepsis were divided into two groups according to the random number table method. The control group received symptomatic treatment and cluster treatment （such as antibiotics, intensive insulin and nutritional support） , while the study group received small dose of methylprednisolone sodium suceinate injection on the basis of the control group for 7 days. Levels of T lymphocytes in peripheral blood, inflammatory indicators（PCT, CRP, IL-8）, sTREM-1, sICAM-1 and sVCAM-1 were detected, PCIS and APACHEⅡ scores were evaluated and clinical outcomes were compared after the treatment. Results Compared with treatment before, the levels of CD3^＋ , CD4^＋ and CD8^＋ inereased（P 〈0.01 ）, levels of CD64^＋ decreased（P 〈0.01 ）, levels of PCT, CRP and IL-8 significantly decreased（P 〈0.01 ） , levels of sTREM-1, sICAM-1, and sVCAM-1 decreased （P 〈 0.01 ）, scores of PCIS increased （ P 〈 0.05 ） , scores of APACHE Ⅱ decreased （ P 〈 0.05）. Compared with the control group, the study group had higher levels of CD3^＋ , CD4^＋ and CD8^＋（ P 〈 0.01） , lower levels of CD64^＋ , PCT, CRP and IL-8 （P 〈 0.01 ） , increased levels of sTREM-1, sICAM -1 , sVCAM- 1 （ P 〈 0.0 1 ） , higher PCIS scores （ P 〈 0.0 5 ） , and lower APACHEⅡ scores （P 〈 0.05）, and higher efficacy rate （P 〈 0.05）. Conclusion Low dose glucocorticoid can effectively reduce levels of serum sTREM-1, PCT, CD64^＋ in children with sepsis.
出处
《实用临床医药杂志》
CAS
2017年第15期41-44,48,共5页
Journal of Clinical Medicine in Practice
基金
湖北省自然科学基金项目(2015CFB143)
关键词
小儿脓毒症
激素
可溶性髓系细胞触发受体1
降钙素原
CD64
pediatric sepsis
hormone
soluble triggering receptor expressed on myeloid cells-1
procalcitonin
CD64
