目的:探讨烧伤脓毒症患儿血浆肾上腺髓质素前体(pro-ADM)及皮质醇(Cor)水平与全身炎症反应及靶器官损伤的关系.方法:收集2014年8月~2016年8月间本院收治的烧伤脓毒症患儿30例作为观察组,同期在本院进行疫苗接种的正常儿童30例作为正常对照组.测定两组研究对象血浆中pro-ADM、Cor的含量,血清炎症因子、心肌损伤标志物、肠屏障功能指标的含量.采用Pearson检验评估烧伤脓毒症患儿血浆pro-ADM、Cor含量与全身炎症反应、靶器官损伤的相关关系.结果:观察组患儿血浆中pro-ADM、Cor的含量高于正常对照组(P<0.05).观察组患儿血清炎症因子IL-1、IL-6、IL-10、TNF-α的含量高于正常对照组;心肌损伤标志物肌酸激酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)、氨基末端脑钠肽前体(NT-proBNP)的含量高于正常对照组;肠屏障功能指标内毒素(ET)、二胺氧化酶(DAO)、D-乳酸(D-L)的含量高于正常对照组(P<0.05).结论:烧伤脓毒症患儿血浆pro-ADM、Cor含量上升,其含量与全身炎症反应、靶器官损伤程度高度一致.%Objective: To study the relationship of plasma proadrenomedullin (pro-ADM) and cortisol (Cor) levels with systemic inflammatory response and target organ damage in children with sepsis after burn.Methods: A total of 30 children with sepsis after burn who were treated in the hospital between August 2014 and August 2016 were collected as observation group, and 30 normal children who received vaccination in the hospital during the same period were collected as normal control group.The pro-ADM and Cor levels in plasma as well as the levels of inflammatory factors, myocardial injury markers and intestinal barrier function indexes in serum of the two groups were determined.Pearson test was used to assess the correlation of plasma pro-ADM and Cor levels with systemic inflammatory response and target organ damage in patients with sepsis after burn.Results: Plasma pro-ADM and Cor levels in observation group were significantly higher than those in normal control group (P<0.05).Serum inflammatory cytokines IL-1, IL-6, IL-10 and TNF-α levels in observation group were higher than those in normal control group;serum myocardial injury markers CK-MB, cTnⅠand NT-proBNP levels were higher than those in normal control group;serum intestinal barrier function indexes ET, DAO and D-L levels were significantly higher than those in normal control group (P<0.05).Conclusion: Plasma pro-ADM and Cor levels increase in patients with sepsis after burn, and are highly consistent with systemic inflammatory response and target organ injury.
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