儿童脓毒症患者氧化应激及肠黏膜通透性的变化

Changes of oxidative stress and intestinal mucosal permeability in children with sepsis

目的探讨儿童脓毒症患者治疗前后氧化应激及肠黏膜通透性的变化。方法选取2016年1月～2017年12月在该院住院治疗的儿童脓毒症患者40例为观察组,予以抗感染、液体复苏、营养支持和原发病治疗等基础治疗。观察治疗前和治疗7 d后血清氧化应激指标[活性氧(ROS)、脂质过氧化氢(LHP)和谷胱甘肽过氧化物酶(GSH-Px)]和肠黏膜通透性指标[内毒素和二胺氧化酶(DAO)]水平的变化。另选择同期在该院体检的正常健康儿童30例为对照组。结果观察组治疗前血清ROS和LHP水平明显高于对照组,血清GSH-Px水平明显低于对照组(P<0.05)。治疗7 d后,血清ROS和LHP水平较治疗前明显下降,血清GSH-Px水平较前明显上升(P<0.05)。同时观察组治疗前血清内毒素和DAO水平明显高于对照组(P<0.05)。治疗7 d后,血清内毒素和DAO水平较治疗前明显下降(P<0.05)。结论儿童脓毒症患者体内存在氧化应激紊乱及肠黏膜通透性异常,在其诊断和治疗中起重要作用。血清ROS、LHP、GSH-Px、内毒素和DAO水平的变化可作为儿童脓毒症患者疗效评价的敏感血清学指标。

Objective To investigate the changes of oxidative stress and intestinal mucosal permeability in children with sepsis before and after treatment.Methods40patients with sepsis who were hospitalized in the hospital from January2016to December2017were selected as the observation group and were given basic treatment such as anti-infection,fluid resuscitation,nutritional support,and primary disease treatment.The changes of serum oxidative stress parameters(reactive oxygen species(ROS),lipid hydroperoxide(LHP)and glutathione peroxidase(GSH-Px))and intestinal mucosal permeability indexes(endotoxin and diamine oxidase(DAO))before treatment and after7days of treatment were observed.Another30normal healthy children who were examined in the same hospital during the same period were selected as the control group.Results The serum ROS and LHP levels in the observation group were significantly higher than those in the control group,and the serum GSH-Px level in the observation group was significantly lower than that in the control group(P<0.05).After7days of treatment,serum ROS and LHP levels were significantly lower than those before treatment,and serum GSH-Px level was significantly higher than that before(P<0.05).At the same time,serum endotoxin and DAO levels in the observation group were significantly higher than those in the control group before treatment(P<0.05).After7days of treatment,the levels of serum endotoxin and DAO were significantly lower than those before treatment(P<0.05).Conclusion There are oxidative stress disorders and intestinal permeability abnormalities in children with sepsis,which play an important role in diagnosis and treatment.The changes of serum ROS,LHP,GSH-Px,endotoxin and DAO levels can be used as sensitive serological markers for evaluating the efficacy of sepsis in children.