血清ADMA、IL-6、内毒素及乳酸在新生儿败血症所致感染性休克中的表达及临床意义

Expression and clinical significance of serum ADMA,IL-6,endotoxin and lactic acid in septic shock caused by neonatal sepsis

目的探讨血清不对称二甲基精氨酸(ADMA)、白细胞介素-6(IL-6)、内毒素及乳酸在新生儿败血症所致感染性休克中的表达及临床意义。方法选取我院收治的58例新生儿败血症所致感染性休克患儿为休克组,62例新生儿败血症未发生感染性休克患儿为败血症组,60例无感染新生儿为对照组。检测所有研究对象血清中的ADMA、IL-6、内毒素及乳酸水平。比较三组研究对象的ADMA、IL-6、内毒素及乳酸水平;分析ADMA、IL-6、内毒素及乳酸水平对新生儿败血症所致感染性休克患儿的诊断价值;分析ADMA水平与IL-6、内毒素及乳酸水平的关系;分析ADMA、IL-6、内毒素及乳酸水平与休克组预后的关系。结果休克组的ADMA、IL-6、内毒素及乳酸水平均高于败血症组及对照组(P<0.05);败血症组的ADMA、IL-6、内毒素水平均高于对照组(P<0.05);败血症组和对照组的乳酸水平无显著差异(P>0.05)。受试者工作特征曲线(ROC)结果显示,ADMA、IL-6、内毒素及乳酸诊断新生儿败血症所致感染性休克的曲线下面积(AUC)分别为0.93、0.89、0.89、0.92。Pearson相关性分析结果显示,ADMA水平与IL-6、内毒素及乳酸水平呈正相关(P<0.05)。ADMA、IL-6、内毒素及乳酸高水平与新生儿败血症所致感染性休克预后不良有关。结论血清ADMA、IL-6、内毒素及乳酸在新生儿败血症所致感染性休克中表达水平较高,可作为该疾病诊断的生物标志物并预测预后。

Objective To investigate the expression and clinical significance of serum asymmetric dimethylarginine(ADMA),interleukin-6(IL-6),endotoxin and lactic acid in septic shock caused by neonatal sepsis.Methods A total of 58 neonates with septic shock caused by neonatal sepsis admitted in our hospital were selected as shock group,62 neonates with neonatal sepsis without septic shock were selected as sepsis group,and 60 neonates without infection were selected as control group.The levels of ADMA,IL-6,endotoxin and lactic acid in serum of all subjects were detected.The levels of ADMA,IL-6,endotoxin and lactic acid in the three groups were compared;the diagnostic value of ADMA,IL-6,endotoxin and lactic acid levels in children with septic shock caused by neonatal sepsis were analyzed;the relationship between ADMA level and IL-6,endotoxin and lactic acid levels were analyzed;the relationship between the levels of ADMA,IL-6,endotoxin and lactic acid and the prognosis of the shock group were analyzed.Results The levels of ADMA,IL-6,endotoxin and lactic acid in the shock group were higher than those in the sepsis group and the control group(P<0.05);the levels of ADMA,IL-6 and endotoxin in the sepsis group were higher than those in the control group(P<0.05);there was no significant difference in lactic acid level between the sepsis group and the control group(P>0.05).The results of receiver operating characteristic curve(ROC)showed that the area under the curve(AUC)of ADMA,IL-6,endotoxin and lactic acid in the diagnosis of septic shock caused by neonatal sepsis were 0.93,0.89,0.89 and 0.92,respectively.Pearson correlation analysis results showed that ADMA level was positively correlated with IL-6,endotoxin and lactic acid levels(P<0.05).High levels of ADMA,IL-6,endotoxin and lactic acid were associated with poor prognosis of septic shock caused by neonatal sepsis.Conclusion Serum ADMA,IL-6,endotoxin and lactic acid are highly expressed in septic shock caused by neonatal sepsis,which can be used as biomarkers for the diagnosis of the disease and predict the prognosis.