可溶性P选择素在重症肺炎并脓毒症患儿中检测的意义  

Clinical significance of soluble P-selectin in children with severe pneumonia accompanying sepsis

作　　者：王程毅[1] 宋朝敏[2] 王世彪[1] 郑启安[1] 张荣娜[2] 黄丽芳[1] 

机构地区：[1]福建省妇幼保健院福建医科大学教学医院儿科,福州350001 [2]福建省妇幼保健院福建医科大学教学医院新生儿科,福州350001

出　　处：《中华实用儿科临床杂志》2015年第18期1398-1400,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：福建省卫生厅青年科研课题立项（2013-2-13）;福建省妇幼保健院院内课题（妇保院研14-12）

摘　　要：目的：分析重症肺炎合并脓毒症患儿可溶性P选择素与临床生物标志物、小儿危重症评分的相关性，探讨检测可溶性P选择素在小儿重症肺炎并脓毒症中的临床意义。方法选择2010年1月至2013年12月在福建省妇幼保健院儿科重症监护病房住院符合重症肺炎合并脓毒症诊断的126例患儿为研究对象。根据脓毒症严重程度分为3组：脓毒症组（71例），严重脓毒症组（42例），脓毒症休克组（13例）。于入院2 h内检测相关临床生物标志物，数据采用SPSS 11.0软件进行统计学分析，采用多元线性逐步回归分析可溶性P选择素与其相关性。结果1.脓毒症组、严重脓毒症组和脓毒症休克组可溶性P选择素、血乳酸、D二聚体、白细胞介素6水平逐渐升高，血小板计数、危重症评分水平逐渐降低，差异有统计学意义（ P〈0.05）；2.重症肺炎合并脓毒症患儿可溶性P选择素与白细胞介素6、D二聚体水平呈正相关，与小儿危重症评分呈负相关。结论检测重症肺炎合并脓毒症患者血清可溶性P选择素水平对其早期诊断和判定患者预后具有重要价值。Objective To study the relevancy between soluble P-selectin and other clinical biomarkers, pe-diatric critical illness score in children with severe pneumonia accompanying sepsis,and to discuss the clinical sig-nificance of soluble P-selectin in children with severe pneumonia accompanying sepsis. Methods One hundred and twenty-six children with severe pneumonia accompanying sepsis admitted to the Pediatric Intensive Care Unit were se-lected from January of 2010 to December of 2013 as research subjects. They were divided into the following groups ac-cording to their severity of their：sepsis group（n=71）,severe sepsis group（n=42） and septic shock group（n=13）. Their biomarkers were detected within 2 h after admission. The data were analyzed by SPSS 11. 0 software,multiple linear regression analysis was made to evaluate the relationship between clinical biomarkers,pediatric critical illness score and soluble P-selectin. Results （1） The average level of soluble P-selectin,blood lactate,D-Dimer and inter-leukin-6 level increased, platelet count level decreased in 3 groups, and there were significant differences among 3 groups（P〈0. 05）. （2）In this research,there were positive correlation between interleukin-6,D-Dimer and soluble P-selectin but negative correlation between pediatric critical illness score and soluble P-selectin. Conclusions The con-centration of the soluble P-selectin may have very important clinical value in the early diagnosis and the prognosis of children with severe pneumonia accompanying sepsis.

关 键 词：脓毒症 重症肺炎 儿童 生物标志物 P选择素 

分 类 号：R720.597[医药卫生—急诊医学]