脓毒症患儿血清E选择素、D－二聚体、降钙素原以及C反应蛋白测定及临床意义

摘要

目的：探讨脓毒症患儿血清E选择素、D－二聚体、降钙素原以及C反应蛋白测定及临床意义。方法选择2014年1月至2015年4月保定市儿童医院收治的严重脓毒症患儿65例（严重脓毒症组）和脓毒症患儿65例（脓毒症组），患儿均进行常规治疗，疗程为14 d。另选65例健康患儿作健康对照组，检测分析患儿的血清E选择素、D－二聚体、降钙素原以及C反应蛋白指标变化。结果治疗前，严重脓毒症组的血清E选择素为（62．7±5．7） mg／L、D－二聚体为（3．72±1．14） mg／L、降钙素原为（9730±214） mg／L，C反应蛋白为（97±10） mg／L，均显著高于脓毒症组[（41．4±4．2） mg／L、（1．63±0．24） mg／L、（3352±16） mg／L、（82±8） mg／L]和健康对照组[（5．8±1．1） mg／L、（0．83±0．12） mg／L、（1681±13） mg／L、（48±11） mg／L]（P＜0．05）；脓毒症组的血清E选择素、D－二聚体、降钙素原以及C反应蛋白高于健康组，差异有统计学意义（P＜0．05）；经治疗14 d后，脓毒症组E选择素（8．7±2．5） mg／L、D－二聚体（1．03±0．14） mg／L、降钙素原（2131±58） mg／L以及C反应蛋白（58±12） mg／L较治疗前降低，差异有统计学意义（P ＜0．01）；严重脓毒症患儿中死亡组（21例） E－选择素、D－二聚体、降钙素原、C 反应蛋白水平均显著高于存活组（44例）[（67±10） mg／L 比（37±10） mg／L、（2．62±0．96） mg／L 比（1．44±0．34） mg／L、（8241±704） mg／L 比（2044±114） mg／L，（85±12） mg／L比（69±12） mg／L]，差异有统计学意义（P＜0．01）。结论对脓毒症患儿的血清E选择素、D－二聚体、降钙素原以及C反应蛋白水平指标的测定可对脓毒症患儿的诊断及预后提供有效的理论依据。%Objective To explore the determination and clinical significance of E-selectin,D-dimer,cal-citonin and C-reactive protein( CRP) levels in pediatric sepsis.Methods Total of 130 patients with sepsis from Baoding Children′s Hospital during Jan.2014 and Apr.2015 were selected in the study,including 65 cases of severe sepsis( severe sepsis group) and 65 cases of sepsis( sepsis group) ,which were given conven-tional treatment for 14 days,and 65 healthy children were included in the study as a control group .The levels of serum E-selectin, D-dimer, procalcitonin and CRP were tested and analyzed.Results The levels of E-selectin (62.7 ±5.7) mg/L,D-dimer(3.72 ±1.14) mg/L,procalcitonin(9730 ±214) mg/L and CRP (97 ±10) mg/L In severe sepsis group,were higher than the sepsis group′s [(41.4 ±4.2) mg/L,(1.63 ± 0.24) mg/L,(3352 ±16) mg/L,(82 ±8) mg/L] and health group′s[(5.8 ±1.1) mg/L,(0.83 ± 0.12) mg/L, (1681 ±13) mg/L,(48 ±11) mg/L](P <0.05); the E-selectin,D-dimer procalcitonin and CRP of sepsis group were higher than the health group(P<0.05);after 14 days of treatment,the E-se-lectin (8.7 ±2.5) mg/L,D-dimer (1.03 ±0.14) mg/L,procalcitonin (2131 ±58) mg/L and CRP (58 ± 12) mg/L of the sepsis group were statistically significant lower than before treatment(P <0.05);In the severe sepsis group,the E-selectin,D-dimer,procalcitonin,CRP level of death group were higher than survival group[(67 ±10) mg/L vs (37 ±10) mg/L,(2.62 ±0.96) mg/L vs (1.44 ±0.34) mg/L,(8241 ±704) mg/L vs (2044 ±114) mg/L,(85 ±12) mg/L vs (69 ±12) mg/L,P<0.01].Conclusion The levels of E-selectin,D-dimer,procalcitonin and CRP test can be used as the theoretical basis for the diagnosis and prognosis of sepsis.