中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2012年
1期
32-34
,共3页
脓毒性休克%肌酸激酶同工酶%α-羟丁酸脱氢酶%乳酸脱氢酶%高密度脂蛋白胆固醇%儿童
膿毒性休剋%肌痠激酶同工酶%α-羥丁痠脫氫酶%乳痠脫氫酶%高密度脂蛋白膽固醇%兒童
농독성휴극%기산격매동공매%α-간정산탈경매%유산탈경매%고밀도지단백담고순%인동
Septic shock%Creatine kinase-MB%α-Hydroxybutyrate dehydrogenase%Lactic dehydrogenase%High density lipoprotein cholesterol%Children
目的 探讨心肌酶及高密度脂蛋白胆固醇与小儿脓毒性休克病情严重程度及预后的关系.方法 2006年1月至2011年3月我科收治脓毒性休克患儿共52例,分为重度脓毒性休克组(27例)和轻度脓毒性休克组(25例).入院时检测脓毒性休克患儿的肌酸激酶同工酶(creatine kinase-MB,CK-MB)、α-羟丁酸脱氢酶(α-hydroxybutyrate dehydrogenase,α-HBDH)、乳酸脱氢酶(lacficdehydrogenase,LDH)及高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)含量,并与健康体检儿童(正常对照组)32例进行对比分析.轻、重度脓毒性休克组患儿于入院后第1、2、4、7、10、15天动态监测以上指标,同时密切观察脓毒性休克患儿的病情变化,记录死亡情况和治愈出院时间.结果 轻、重度感染性休克组患儿入院时血清CK-MB[ (32.084±4.595) U/L、(61.481±5.639) U/L]较对照组[(21.675±3.453) U/L]明显升高；α-HBDH/LDH(0.694±0.080、0.884±0.079)较对照组(0.443±0.065)明显升高；HDL-C[ (0.646±0.067) mmol/L、(0.310±0.124) mmol/L]较对照组[(1.012±0.156) mmol/L]明显降低,3组间比较差异有统计学意义(P均＜0.01).重度脓毒性休克组死亡5例,轻度组无死亡病例.重度脓毒性休克组患儿较轻度组在CK-MB恢复时间[(9.82±1.76)d vs (4.68±1.22)d]、α-HBDH/LDH恢复时间[(7.23±1.38)d vs (3.76±0.83)d]、HDL-C恢复时间[(12.14±2.21)d vs (6.48±1.33)d]及住院时间[(15.09±2.69)d vs (7.40±1.58)d]方面明显延长,两组比较差异均有统计学意义(P均＜0.01).结论脓毒性休克患儿血清CK-MB、α-HBDH/LDH越高,HDL-C越低,其病情越重,恢复时间越长,预后越差.
目的 探討心肌酶及高密度脂蛋白膽固醇與小兒膿毒性休剋病情嚴重程度及預後的關繫.方法 2006年1月至2011年3月我科收治膿毒性休剋患兒共52例,分為重度膿毒性休剋組(27例)和輕度膿毒性休剋組(25例).入院時檢測膿毒性休剋患兒的肌痠激酶同工酶(creatine kinase-MB,CK-MB)、α-羥丁痠脫氫酶(α-hydroxybutyrate dehydrogenase,α-HBDH)、乳痠脫氫酶(lacficdehydrogenase,LDH)及高密度脂蛋白膽固醇(high density lipoprotein cholesterol,HDL-C)含量,併與健康體檢兒童(正常對照組)32例進行對比分析.輕、重度膿毒性休剋組患兒于入院後第1、2、4、7、10、15天動態鑑測以上指標,同時密切觀察膿毒性休剋患兒的病情變化,記錄死亡情況和治愈齣院時間.結果 輕、重度感染性休剋組患兒入院時血清CK-MB[ (32.084±4.595) U/L、(61.481±5.639) U/L]較對照組[(21.675±3.453) U/L]明顯升高；α-HBDH/LDH(0.694±0.080、0.884±0.079)較對照組(0.443±0.065)明顯升高；HDL-C[ (0.646±0.067) mmol/L、(0.310±0.124) mmol/L]較對照組[(1.012±0.156) mmol/L]明顯降低,3組間比較差異有統計學意義(P均＜0.01).重度膿毒性休剋組死亡5例,輕度組無死亡病例.重度膿毒性休剋組患兒較輕度組在CK-MB恢複時間[(9.82±1.76)d vs (4.68±1.22)d]、α-HBDH/LDH恢複時間[(7.23±1.38)d vs (3.76±0.83)d]、HDL-C恢複時間[(12.14±2.21)d vs (6.48±1.33)d]及住院時間[(15.09±2.69)d vs (7.40±1.58)d]方麵明顯延長,兩組比較差異均有統計學意義(P均＜0.01).結論膿毒性休剋患兒血清CK-MB、α-HBDH/LDH越高,HDL-C越低,其病情越重,恢複時間越長,預後越差.
목적 탐토심기매급고밀도지단백담고순여소인농독성휴극병정엄중정도급예후적관계.방법 2006년1월지2011년3월아과수치농독성휴극환인공52례,분위중도농독성휴극조(27례)화경도농독성휴극조(25례).입원시검측농독성휴극환인적기산격매동공매(creatine kinase-MB,CK-MB)、α-간정산탈경매(α-hydroxybutyrate dehydrogenase,α-HBDH)、유산탈경매(lacficdehydrogenase,LDH)급고밀도지단백담고순(high density lipoprotein cholesterol,HDL-C)함량,병여건강체검인동(정상대조조)32례진행대비분석.경、중도농독성휴극조환인우입원후제1、2、4、7、10、15천동태감측이상지표,동시밀절관찰농독성휴극환인적병정변화,기록사망정황화치유출원시간.결과 경、중도감염성휴극조환인입원시혈청CK-MB[ (32.084±4.595) U/L、(61.481±5.639) U/L]교대조조[(21.675±3.453) U/L]명현승고；α-HBDH/LDH(0.694±0.080、0.884±0.079)교대조조(0.443±0.065)명현승고；HDL-C[ (0.646±0.067) mmol/L、(0.310±0.124) mmol/L]교대조조[(1.012±0.156) mmol/L]명현강저,3조간비교차이유통계학의의(P균＜0.01).중도농독성휴극조사망5례,경도조무사망병례.중도농독성휴극조환인교경도조재CK-MB회복시간[(9.82±1.76)d vs (4.68±1.22)d]、α-HBDH/LDH회복시간[(7.23±1.38)d vs (3.76±0.83)d]、HDL-C회복시간[(12.14±2.21)d vs (6.48±1.33)d]급주원시간[(15.09±2.69)d vs (7.40±1.58)d]방면명현연장,량조비교차이균유통계학의의(P균＜0.01).결론농독성휴극환인혈청CK-MB、α-HBDH/LDH월고,HDL-C월저,기병정월중,회복시간월장,예후월차.
Objective To investigate the changes of serum myocardial enzymes and high density lipoprotein cholesterol(HDL-C) in children with septic shock.Methods Fifty-two children with septic shock in our hospital from Jan 2006 to Mar 2011 were divided into severe septic shock group( n =27 ) and mild septic shock group ( n =25 ).The serum creatine kinase-MB ( CK-MB ),α-hydroxybutyrate dehydrogenase (α-HBDH),lactic dehydrogenase(LDH) and HDL-C were analysed in both two groups on 1,2,4,7,10,15 d,and compared with 32 normal children as control group.Meanwhile,the children's condition,death cases and cured time were recorded.Results The levels of serum CK-MB [ ( 32.084 ± 4.595 ) U/L,( 61.481 ±5.639) U/L],α-HBDH/LDH(0.694 ±0.080,0.884 ±0.079) in mild and severe septic shock groups were higher than those of normal control group[ (21.675 ± 3.453) U/L ] and (0.443 ± 0.065 ) ( P ＜ 0.01 ) ;the levels of serum HDL-C[ (0.646 ±0.067) mmol/L,(0.310 ± 0.124) mmol/L ] in the two septic shock groups were decreased significantly than that of control group[ ( 1.012 ±0.156) mmol/L] (P ＜0.01 ).Five cases died in the severe septic shock group while no cases died in mild septic shock group.The times of CK-MB recovered[ (9.82 ±1.76) d vs (4.68 ± 1.22) d],α-HBDH/LDH recovered[ (7.23 ± 1.38) d vs (3.76 ± 0.83 ) d] and HDL recovered[ ( 12.14 ± 2.21 ) d vs ( 6.48 ± 1.33 ) d ] were more slowly in severe septic shock group than those of mild septic shock group( P ＜ 0.01 ).Conclusion The higher of the serum CK-MB and α-HBDH/LDH,and the lower of HDL-C in septic shock children,the disease is more severe,the recovery time is longer and a worse prognosis may occur.
