摘要
目的本研究通过测定促炎和抗炎两方面的代表性细胞因子——白细胞介素（interleu—kin，IL）-6和IL-10，判断tDJL肺炎相关脓毒症的炎症反应水平及其在病程中的变化。方法将2008年9月至2009年3月收入PICU的62例肺炎患儿分为肺炎组（n=31）、脓毒症组（n：20）、严重脓毒症组（n=11），分别测定入PICU第1天和第4天的血清IL-6和IL-10水平。结果严重脓毒症组患儿的小儿死亡危险评分Ⅲ及病死率显著高于肺炎组和脓毒症组，差异有统计学意义（P〈0．05）。肺炎组、脓毒症组、严重脓毒症组患儿在入PICU第1天的血清IL-6水平依次递增，分别为（55．68±61．41）pg／ml、（57．46±96．56）pg／ml及（114．86±206.37）pg／ml，但差异不具有统计学意义（P〉0．05）；1L-10水平则依次递减，分别为（59．50＋57．97）pg／ml、（41．27±28．37）pg／ml及（20．05±9．14）pg／ml，差异具有统计学意义（P〈0．05）；IL-6／IL-10分别为1．51±2．42、1．48±2．50、14．47±26．97，差异具有统计学意义（P〈0．05）。入PICU第4天3组患儿血清IL-6、IL-10及IL-6／IL-10的差异均没有统计学意义（P〉0．05）。结论血清IL-10水平可能有助于评估儿童肺炎相关脓毒症的严重程度，IL-6／IL-10升高提示预后不良。
Objective To determine the changes of the host＇s inflammatory response throughout the course of sepsis secondary to pneumonia by evaluating the serum levels of interleukin （IL）-6 and IL-10. Methods Sixty-two patients who were diagnosed with pneumonia and hospitalized in PICU from Sep 2008 to Mar 2009 were enrolled in this study. They were divided into 3 groups：pneumonia group （n = 31 ）, sepsis group （ n = 20） and severe sepsis group （ n = 11 ）. The serum levels of IL-6 and Ⅱ-10 were measured by enzyme-linked iInmunosorbent assay at the day 1 and day 4 after admitted to PICU. Results The pediatric risk of score mortality Ⅲ scores and fatality rate were significantly higher in severe sepsis group compared to the other two groups （ P 〈 0. 05 ）. The levels of IL-6 were （ 55.68 ±61.41 ） pg/ml, （ 57.46 ±96. 56） pg/ml, and （114. 86±206. 37） pg/ml in pneumonia group,sepsis group and severe sepsis group at day 1 of PICU,with no difference among 3 groups. However, the levels of IL-10 were （ 59. 50 ±57.97 ） pg/ml, （ 41.27 ± 28.37 ） pg/ml, and（ 20. 05 ± 9. 14 ） pg/ml at day 1 in 3 groups, which showed a significant difference （ P 〈 0.05）. The ratio of IL-6 to IL-10 were 1.51 ±2.42,1.48 ±2. 50,and 14.47±26.97 at day 1 in 3 groups. There was a significant differrence among 3 groups （ P 〈 0.05 ）. No difference was found among 3 groups at day 4. Conclusion IL-10 may be an determinant factor of the severity and prognosis of the sepsis,and measurement of IL-10 or the ratio of IL-6 to IL-10 can be used to evaluate the severity and prognosis of sepsis.
出处
《中国小儿急救医学》
CAS
2012年第2期152-154,共3页
Chinese Pediatric Emergency Medicine
