急性腺病毒肺炎合并脓毒症患儿血清降钙素原、白细胞介素-6、肿瘤坏死因子-α水平变化的临床意义

Clinical Significance of Serum Procalcitonin,Interleukin-6 and Tumor Necrosis Factor-α in Children of Acute Adenovirus Pneumonia Complicated with Sepsis

目的:研究分析急性腺病毒肺炎合并脓毒症患儿血清降钙素原、白细胞介素-6、肿瘤坏死因子-α水平变化的临床意义,为临床诊断及治疗提供指导。方法:选取本院在2015年7月-2017年1月收治的120例腺病毒肺炎患者为研究对象,按照小儿脓毒症肺炎诊断的标准,将患者分为非脓毒症组60例、脓毒症组60例,同时选取同期体检的40例健康儿童作为对照组。在入院当天、第3、7天采集患者外周静脉血2 mL,离心10 min,采取双抗体夹心ELISA法测定研究对象的白细胞介素-6、血清降钙素原、肿瘤坏死因子-α的水平,比较三组患者血清白细胞介素-6、血清降钙素原、肿瘤坏死因子-α水平的差异,并比较预后效果不同的患者血清白细胞介素-6、血清降钙素原、肿瘤坏死因子-α水平的差异。结果:第1、3、7天脓毒症组以及非脓毒症组患者血清IL-6、PCT、TNF-α水平均显著高于对照组(P<0.05),且脓毒症组显著高于非脓毒症组患者(P<0.05)。预后良好组患者血清白细胞介素-6、血清降钙素原、肿瘤坏死因子-α均明显低于预后不佳组(P<0.05)。结论:血清PCT、IL-6、TNF-α的检测简便、准确、经济,急性腺病毒肺炎的患者血清PCT、IL-6、TNF-α水平可用于判断腺病毒肺炎合并脓毒症的严重程度,有助于临床上早期准确诊断、治疗及预后评估。

Objective： To study the clinical significance of serum levels of procalcitonin, interleukin-6 and tumor necrosis factor- α in children of acute adenovirus pneumonia complicated with sepsis, and to provide guidance for clinical diagnosis and treatment.Method： 120 patients with adenovirus pneumonia who were admitted in our hospital from July 2015 to January 2017 were selected as the subjects.According to the standard of diagnosis of pneumonia in children, the patients were divided into non-sepsis group of 60 cases, sepsis group of 60 cases, while 40 healthy children were selected as the control group.The levels of serum procalcitonin, interleukin-6 and tumor necrosis factor- α of three groups were measured by double antibddy sandwich ELISA on the day of admission, the third day and the seventh day, and the peripheral venous blood was collected for 2 mL, 10 min/r.The differences of serum PCT, IL-6 and TNF- α levels of three groups were compared.The difference of serum PCT, IL-6 and TNF- α levels in patients with different prognosis were compared.Result： The levels of serum PCT, IL-6 and TNF- α in non-sepsis group and sepsis group were significantly higher than those of control group on first, third and seventh day （ P〈0.05 ） .The levels of serum PCT, IL-6 and TNF- α in sepsis group were significantly higher than those in non-sepsis group on first, third and seventh day （ P〈0.05 ） . The levels of PCT, IL-6 and TNF- α in patients with good prognosis were significantly lower than those with poor prognosis （ P〈0.05 ） .Conclusion： The detection of PCT, IL-6 and TNF- α in serum is simple, accurate and economical.The levels of serum PCT, IL-6 and TNF- α in patients with acute adenovirus pneumonia can be used to judge the severity of sevovirus pneumonia complicated with sepsis, which is helpful for early diagnosis,treatment and prognosis.