摘要
目的探讨脓毒症病儿血清中调节性T细胞(Treg)、乳酸(Lac)、脂联素(APN)动态变化及与病情严重程度关系。方法回顾性分析2023年1月—2024年6月我院收治的138例脓毒症病儿病例资料,根据病情严重程度将病儿分为轻中度组(60例)和重度组(78例),重度组根据7 d内预后情况分为存活组(63例)和死亡组(15例)。对不同时间血清Treg、Lac及APN水平进行组间比较,并分析重度组病儿入院时血清Treg、Lac及APN水平与急性生理与慢性健康评分系统(APACHE-Ⅱ)评分的关系。结果入院时和入院后24、48 h时,与轻中度组比较,重度组血清Treg、Lac水平均增高,血清APN水平降低,差异均有统计学意义(F=6.892~10.623,P<0.001);死亡组各时间点的血清Treg、Lac水平均显著高于存活组,而血清APN水平低于存活组(F=7.253~12.744,P<0.001)。重度组病儿入院时血清Treg及Lac水平与APACHE-Ⅱ评分呈显著正相关(r=0.857、0.912,P<0.01),而血清APN水平与APACHE-Ⅱ评分呈显著负相关(r=-0.886,P<0.01)。结论在重度脓毒症病儿中,血清Treg、Lac和APN水平与病情严重程度相关。
Objective To investigate the dynamic changes of serum regulatory T cells(Treg),lactate(Lac),and adiponectin(APN)and their association with disease severity in children with sepsis.Methods A retrospective analysis was performed for the case data of 138 children with sepsis who were admitted to our hospital from January 2023 to June 2024,and according to disease severity,they were divided into mild-to-moderate group with 60 children and severe group with 78 children.According to the prognosis within 7 days,the severe group was further divided into survival group with 63 children and death group with 15 children.The serum levels of Treg,Lac,and APN at different time points were compared between groups,and the children in the severe group were analyzed in terms of the correlation of the serum levels of Treg,Lac,and APN on admission with Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score.Results Compared with the mild-to-moderate group,the severe group had significant increases in the serum levels of Treg and Lac and a significant reduction in the serum level of APN on admission and at 24 and 48 hours after admission(F=6.892-10.623,P<0.001),and compared with the survival group,the death group had significantly higher serum levels of Treg and Lac and a significantly lower serum level of APN at each time point(F=7.253-12.744,P<0.001).For the children in the severe group,the serum levels of Treg and Lac on admission were significantly positively correlated with APACHEⅡscore(r=0.857,0.912,P<0.01),while the serum level of APN was significantly negatively correlated with APACHEⅡscore(r=-0.886,P<0.01).Conclusion The serum levels of Treg,Lac,and APN are correlated with disease severity in children with severe sepsis.
作者
马晓雪
郭春霞
赵秀梅
MA Xiaoxue;GUO Chunxia;ZHAO Xiumei(Department of Pediatric Intensive Medicine,Handan Maternal And Child Health Care Hospital,Handan 056000,China)
出处
《青岛大学学报（医学版）》
CAS
2024年第5期755-759,共5页
Journal of Qingdao University(Medical Sciences)
基金
邯郸市科学技术研究与发展计划项目(2142208-3080)。
