脓毒症患儿血清Ang2水平变化与病情严重程度的研究  

Diagnostic Value of Serum Ang2 Protein Levels in Children with Sepsis

作　　者：徐丽丹[1] 王凯旋[1] 李小兵[1] 季秀梅[1] 姜雪燕[1] 唐红娟[1] XU Lidan;WANG Kaixuan;LI Xiaobing;JI Xiumei;JIANG Xueyan;TANG Hongjuan(Jinhua Municipal Central Hospital,Zhejiang 321000,China)

机构地区：[1]金华市中心医院,浙江金华321000

出　　处：《浙江医学教育》2020年第2期48-50,共3页Zhejiang Medical Education

基　　金：浙江省医药卫生一般研究计划(编号:2015KYB416)。

摘　　要：目的:探讨血管生成素2(Ang2)水平在评估儿童脓毒症病情严重程度中的意义。方法:将64名感染患儿按脓毒症分级标准分为3组:脓毒症组(A组)22例、感染不伴全身炎症反应综合征组(B组)24例、重症脓毒症组(C组)18例,同时以同期门诊体检儿童21例作对照组。通过ELISA法测试患儿血清Ang2水平,同时检测外周血降钙素原(PCT)、白细胞计数(WBC)、C反应蛋白(CRP)水平,最终形成ROC曲线,分析并比较Ang2、PCT、WBC、CRP在脓毒症诊断中的敏感度、特异度。结果:各研究组血清Ang2水平比较提示,严重脓毒症组儿童血清Ang2水平显著高于对照组、感染不伴SIRS组及脓毒症组,4组比较差异具有统计学意义(P<0.05)。当血清Ang-2的截断水平为163.4ng/L时,预测儿童严重脓毒症的敏感度达到100%,特异度达98.5%,ROC曲线下面积为0.998(95%CI:0.946-1.00)。结论:严重脓毒症患儿血清Ang2水平明显升高,血清Ang2水平可用于辅助判断儿童脓毒症病情的严重程度。[Objective]To assess the diagnostic value of serum angiopoietin2(Ang 2)levels in children with sepsis.[Method]Sixty-four infected children were divided into three groups according to whether they suffered from sepsis or not:group A(n=22,children with sepsis),group B[(n=24),children with infection and without systemic inflammatory response syndrome(SIRS)],and group C(n=18,children with severe sepsis).In the same period,another 21 children underwent he alth examination in Department of Child Healthcare,Jinhua Municipal Central Hospital were included into control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of Ang2.The levels of peripheral blood procalcitonin(PCT),white blood cell(WBC)and C-reactive protein(CRP)levels were also detected.The areas under the curve(AUC)of receiver operating characteristic(ROC)curve of Ang2,PCT,WBC and CRP in diagnosing sepsis were compared.The sensitivity,specificity of these indicators in diagnosis of sepsis were analyzed.[Result]The levels of serum Ang2 in severe sepsis were higher than those in the control group,the group of infection without SIRS and the sepsis group.The difference was significant(P<0.05).The optimal critical value of serum Ang-2 level to predict children with severe sepsis was163.4ng/L,and its sensitivity and specificity for diagnosis of children with severe sepsis were100% and 98.5%,respectively.The area under the ROC curve was 0.998(95%CI:0.946-1.00).[Conclusion]Serum Ang2 levels in children with severe sepsis are significantly elevated.It can be used to help determine the severity of sepsis in children.

关 键 词：血管生成素2 儿童 脓毒症 

分 类 号：R720.597[医药卫生—急诊医学]