儿童脓毒症血清胆碱酯酶的临床价值研究  

Clinical value of serum cholinesterase of children with sepsis

作　　者：吕贞燕[1] 疏恒[1] 

机构地区：[1]南京医科大学附属无锡市人民医院PICU,江苏无锡214023

出　　处：《中华医院感染学杂志》2016年第18期4201-4203,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨血清胆碱酯酶(CHE)在评估脓毒症患儿病情轻重及预后中的临床意义。方法选取2013年1月-2015年8月医院儿童重症监护病房(PICU)确诊为脓毒症的患儿81例,根据感染程度,分为脓毒症组45例和严重脓毒症/脓毒性休克组(严重脓毒症组)36例,并选取同期非感染患儿作为对照组50例;脓毒症组A和B两组按小儿危重病例评分法(PCIS)分值分为非危重患儿27例、危重患儿32例和极危重患儿22例;比较CHE与降钙素原(PCT)、C-反应蛋白(CRP)、白蛋白(Alb)水平在不同病情程度和结局中的差异,以及CHE与其他各指标的相关性。结果 CHE、Alb、PCT、CRP水平在三组中以及非危重、危重和极危重患儿中比较差异均有统计学意义(P<0.05);死亡患儿CHE、Alb水平明显低于存活患儿和对照组(P<0.05),而PCIS、PCT和CRP明显升高(P<0.05);Pearson相关分析CHE与PCIS、Alb呈正相关(r=0.74,P<0.01;r=0.65,P<0.01),与PCT、CRP呈负相关(r=-0.79、P<0.01,r=-0.59、P<0.05)。结论血清CHE水平是有效评估脓毒症患儿病情轻重和预后的检验指标,结合PCIS、PCT、Alb、CRP水平综合评估效果更好。OBJECTIVE To explore the clinical significance of serum cholinesterase（CHE）in evaluation of illness condition and prognosis of children with sepsis.METHODS Totally 81 children with confirmed sepsis who were treated in pediatric intensive care unit（PICU）from Jan 2013 to Aug 2015 were enrolled in the study and divided into the sepsis group with 45 cases and the severe sepsis or septic shock group（the severe sepsis group）with 36 cases,meanwhile,50 children without infections were set as the control group.The sepsis group A and the sepsis group B were divided into the non-critically ill children（27cases）,critically ill children（32cases）,and extremely critically ill children（22cases）.The levels of CHE,procalcitonin（PCT）,C-reactive protein（CRP）,and albumin（Alb）were observed and compared among the children with different severities of disease and prognosis,and the correlation between the CHE and other indicators was analyzed.RESULTS There was significant difference in the level of CHE,Alb,PCT,or CRP among the three groups or among the non-critically ill children,critically ill children,and extremely critically ill children（P〈0.05）.The levels of CHE and Alb of the children who died were significantly lower than those of the children who survived and the children in the control group（P〈0.05）,however,the levels of PCIS,PCT,and CRP were remarkably elevated（P〈0.05）.The Pearson correlation analysis showed that the CHE was positively correlated with the PCIS（r=0.74,P〈0.01;r=0.65,P〈0.01）but was negatively correlated with PCT and CRP（r=-0.79,P〈0.01,r=-0.59、P〈0.05）.CONCLUSION The serum CHE level is an effective test indicator for evaluation of severity of illness condition and prognosis of the children with sepsis,and it can achieve better effect on comprehensive evaluation when combining with the levels of PCIS,PCT,Alb,and CRP.

关 键 词：血清胆碱酯酶 脓毒症 预后 

分 类 号：R446[医药卫生—诊断学]