血浆内皮素-1对婴幼儿感染性肺炎致急性呼吸窘迫综合征的早期诊断价值  

Early Diagnosis Value of Blood Plasma Endothelin-1 on Acute Respiratory Distress Syndrome Induced by Severe Infantile Infectious Pneumonia

作　　者：李娟[1] 秦勤[1] 赵瑞云[1] 赵须霞[1] 喻文亮[1] 

机构地区：[1]南京医科大学附属南京儿童医院急诊科,南京210008

出　　处：《实用儿科临床杂志》2011年第18期1397-1399,共3页Journal of Applied Clinical Pediatrics

基　　金：江苏省自然科学基金项目(BK2008074)

摘　　要：目的探讨血浆内皮素-1(ET-1)对婴幼儿感染性肺炎所致急性呼吸窘迫综合征(ARDS)的早期诊断价值。方法收集2004年10月1日-2009年9月30日本院PICU诊断为重症感染性肺炎30例(重症肺炎组)、感染性肺炎所致ARDS患儿22例及30例对照组儿童资料。应用放射免疫法,均于入院时或ARDS确诊时测定患儿血浆ET-1水平,测定血氧分压/吸氧体积分数[Pa(O2)/FiO2],并进行小儿危重病例评分及肺损伤评分。结果重症肺炎组、重症肺炎ARDS组入院时及确诊时,pa(O2)/FiO2均显著低于对照组(t=11.334、12.917、28.497,Pa=0.000),危重病例评分均显著低于对照组(t=16.717、12.917、17.427,Pa=0.000),急性肺损伤评分均显著高于对照组(t=22.668、26.951、28.489,Pa=0.000);对照组,重症肺炎组,重症肺炎ARDS组入院时及确诊时血浆ET-1水平分别为(67.8±5.3)ng.L-1、(70.1±8.4)ng.L-1、(113.0±9.9)ng.L-1、(125.4±14.8)ng.L-1,重症肺炎ARDS组入院时及确诊时ET-1水平均显著高于重症肺炎组(t=16.6、15.6,Pa=0.000)。结论婴幼儿重症感染性肺炎于入院时检测ET-1水平可能有助于ARDS的早期诊断。Objective To explore the role of endothelin-1（ET-1） in early diagnosis of acute respiratory distress syndrome（ARDS） induced by severe infantile infectious pneumonia. Methods From Oct.1,2004 to Sep.30,2009,ET-1 values were measured at admission for 30 cases of control group,30 cases of severe infectious pneumonia group,and were measured at admission for 22 severe pneumonia patients who developed ARDS（pneumonia ARDS group）,using radioimmunoassay. Partial pressure of oxygen in artery [pa（O2）]/fractional concentration of inspired oxygen（FiO2） value were measured in all patients. All patients were evaluated at admission and the time point of ARDS developed by Chinese pediatric critical index of severity score（PCIS） and lung injury score. Results In severe pneumonia group,pneumonia ARDS group pre-ARDS and ARDS,pa（O2）/FiO2 were significantly lower than that in control group（t=11.334,12.917,28.497,Pa=0.000）,PCIS score were significantly lower than that in control group（t=16.717,12.917,17.427,Pa=0.000）,lung injury score were significantly higher than in control group（t=22.668,26.951,28.489,Pa=0.000）.The ET-1 levels in control group,severe pneumonia group,pneumonia ARDS group pre-ARDS and ARDS were（67.8±5.3） ng·L-1,（70.1±8.4） ng·L-1,（113.0±9.9） ng·L-1,（125.4±14.8） ng·L-1,respectively.The ET-1 levels in pneumonia ARDS group pre-ARDS and ARDS（t=16.6,15.6,Pa=0.000） were significantly higher than those in pneumonia group. Conclusion Measuring ET-1 level at admission for severe infantile pneumonia is feasible for early diagnosis of ARDS.

关 键 词：感染性肺炎 急性呼吸窘迫综合征 内皮素-1 

分 类 号：R725.6[医药卫生—儿科]