危重儿血清胆碱酯酶与病危程度及预后的相关性分析  

Correlation Analysis of Serum Cholinesterase and Disease Severity and Prognosis in Critical Ill Children

作　　者：樊省廉 何勤 王鹰 

机构地区：[1]广西桂林市人民医院,广西桂林541002

出　　处：《中国医学创新》2014年第12期44-46,共3页Medical Innovation of China

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2011509)

摘　　要：目的：探讨血清胆碱酯酶对危重儿病危程度及预后的判断价值。方法：按小儿危重病例评分法（PCIS）进行评分，选取2011年3月-2013年11月收入本院儿科病房的225例患儿，将其分为非危重组（评分〉81分）80例、危重组（评分71-81分）80例、极危重组（评分〈71分）65例，分别于入院后24 h内检测血清胆碱酯酶活性，并用多系统器官功能衰竭（MSOF）诊断标准评价系统器官功能，分析血清胆碱酯酶、PCIS评分、MSOF之间的相关性。结果：极危重组血清胆碱酯酶活性明显低于危重组，危重组明显低于非危重组，不同PCIS评分组间的血清胆碱酯酶、MSOF发生率与死亡率比较，PCIS评分越低，血清胆碱酯酶活性越低，多器官功能衰竭发生率越高，死亡率越高，差异均有统计学意义（P〈0.01）。结论：危重病例评分越低者，血清胆碱酯酶活性下降越明显，多器官功能衰竭发生率越高及病死率越高，故血清胆碱酯酶活性测定可作为评判危重儿病危程度及预后的一项指标。Objective：To explore the value of serum cholinesterase in determining the disease severity and prognosis in critical ill children.Method：225 pediatric patients were admitted in our pediatric wards from March 2011 to November 2013.According to Pediatric Critical Illness Score（PCIS）,they were divided into the non-critical ill group for 80 cases（〉81 points）,the critical ill group for 80 cases（71-81 points）and the extremely critical ill group for 65 cases（〈71 points）.The serum cholinesterase activity was detected within 24 hours after admission.The system and organs functions were evaluated according to the diagnostic criteria of Multi-Organ System Failure（MSOF）.The correlation of serum cholinesterase and PCIS score and MSOF was analyzed.Result：Serum cholinesterase activity in the extremely critical ill group was significantly lower than the critical ill group,and that in the critical ill group was significantly lower than the non-critical ill group.The serum cholinesterase,MSOF incidence and mortality were compared among different groups with different PCIS scores.It was found that the lower the PCIS score,the lower the serum cholinesterase activity,the higher the MSOF incidence,the higher the mortality,the differences were statistically significant（P〈0.01）.Conclusion：According to our results,the lower the PCIS score,the lower the serum cholinesterase activity,the higher the MSOF incidence and the mortality.Therefore,determining serum cholinesterase activity may be an indicator of determining the disease severity and prognosis in critical ill children.

关 键 词：胆碱酯酶 小儿危重病例评分 多系统器官功能衰竭 

分 类 号：R720.597[医药卫生—急诊医学]