脓毒症患儿sTREM-1、suPAR、Cor、IL-IR1及APC的变化及其意义

Changes and significance of sTREM-1,suPAR,Cor,IL-IR1 and APC of children with sepsis

目的探讨脓毒症患儿血清可溶性髓样细胞触发受体-1(s TREM-1)、可溶性尿激酶型纤溶酶原激活物受体(su PAR)、皮质醇(Cor)、白细胞介素受体-1(IL-IR1)及活性蛋白C(APC)的变化及其意义。方法选取湖南省妇幼保健院确诊的脓毒症患儿90例(脓毒症组)、非感染性全身炎症反应综合征患儿37例(NISIRS组)、同期健康儿童60例作为对照组,收集时间2014年1月-2017年2月。检测并比较3组的s TREM-1、su PAR、Cor、IL-IR1及APC的水平,并分析其与不同病情脓毒症患儿的关系。结果脓毒症组患儿血清s TREM-1、su PAR、Cor、IL-IR1及APC水平均高于NISIRS组和对照组(P<0.05),NISIRS组血清s TREM-1、su PAR、Cor、IL-IR1及APC水平均高于对照组(P<0.05);脓毒症休克组患儿血清s TREM-1、su PAR、Cor、IL-IR1、APC水平及PCIS评分均高于一般脓毒症组、严重脓毒症组(P<0.05),严重脓毒症组的血清s TREM-1、su PAR、Cor、IL-IR1、APC水平及小儿危重症评分(PCIS)均显著的高于一般脓毒症组(P<0.05);脓毒症休克组患儿的血清s TREM-1、su PAR、Cor、IL-IR1及APC水平与PCIS评分均呈显著的负相关关系(P<0.05)。结论脓毒症患儿的s TREM-1、su PAR、Cor、IL-IR1及APC的水平较健康儿童、SIRS患儿均显著升高,并且与病情严重程度具有一定的关系。

Objective To investigate the changes and significance of soluble myeloid cell-triggered receptor-1（ s TREM-1）,solubleurokinase-type plasminogen activator receptor（ su PAR）,cortisol（ Cor）,interleukin-1 receptor（ IL-IR1） and active protein C（ APC） of children with sepsis. Methods From January 2014 to February 2017,ninety sepsis children（ sepsis group）,37 noninfected children with systemic inflammatory response syndrome（ NISIRS group） were selected as the sepsis group and the NISIRS group,respectively and 60 healthy children at the same period were selected as the control group. The levels of s TREM-1,su PAR,Cor,IL-IR1 and APC in the three groups were detected and compared among different sepsis patients. Results The levels of serum s TREM-1,su PAR,Cor,IL-IR1 and APC in children with sepsis were higher than those in the NISIRS group and the control group（ P〈0. 05）. All of the levels of serum s TREM-1,su PAR,Cor,IL-IR1 and APC in the NISIRS group were higher than those in the control group（ P〈0. 05）. The serum levels of s TREM-1,su PAR,Cor,IL-IR1 APC and PCIS in the children with septic shock were higher than those of the general sepsis group and the severe sepsis group（ P〈0. 05）. The levels of serum s TREM-1,su PAR,Cor,ILIR1 APC and PCIS in patients with severe sepsis were significantly higher than those in the general sepsis group（ P〈0. 05）. There was a significantly negative correlation between the serum levels of s TREM-1,su PAR,Cor,IL-IR1 and APC,and the PCIS score in the children with septic shock（ P〈0. 05）. Conclusion The levels of s TREM-1,su PAR,Cor,IL-IR1 and APC in sepsis children were significantly higher than those in healthy children and SIRS children,and there was a certain relationship with the severity of sepsis.