CAJ | 학술논문

目的评价血液肿瘤患儿并发脓毒症时血清巨噬细胞移动抑制因子( macrophage migration inhibitory factor,MIF)的临床意义.方法 (1)以收入我院PICU的血液肿瘤合并脓毒症患儿(27例)为研究对象,同时期我院血液肿瘤化疗后骨髓抑制继发感染但尚未达到脓毒症诊断标准的患儿为非脓毒症组,共14例.(2)脓毒症组、非脓毒症组患儿分别在入院24h内留取血清标本,比较两组间血清MIF、促肾上腺皮质激素释放激素(corticotropin releasing hormone,CRH)、皮质醇、铁蛋白水平.采用多元回归分析方法研究MIF与CRH、皮质醇、小儿危重病例评分(pediatric critical illness score,PCIS)之间的关系.结果脓毒症组患儿MIF水平[(5022.71±3 915.82) pg/ml]较非脓毒症组[(1 722.81±1 738.53) pg/ml]明显升高(P =0.001).多元线性回归分析结果显示,PCIS和CRH是MIF的相关因素(t=-2.830,P=0.009;t=2.852,P=0.009).CRH越高,PCIS越低,MIF越高.结论 MIF一定程度上反映了血液肿瘤患儿合并脓毒症时疾病的严重程度,MIF越高,PCIS越低,疾病越严重.MIF与脓毒症患儿肾上腺皮质功能存在一定联系.
목적 평개혈액종류환인병발농독증시혈청거서세포이동억제인자( macrophage migration inhibitory factor,MIF)적림상의의.방법 (1)이수입아원PICU적혈액종류합병농독증환인(27례)위연구대상,동시기아원혈액종류화료후골수억제계발감염단상미체도농독증진단표준적환인위비농독증조,공14례.(2)농독증조、비농독증조환인분별재입원24h내류취혈청표본,비교량조간혈청MIF、촉신상선피질격소석방격소(corticotropin releasing hormone,CRH)、피질순、철단백수평.채용다원회귀분석방법연구MIF여CRH、피질순、소인위중병례평분(pediatric critical illness score,PCIS)지간적관계.결과 농독증조환인MIF수평[(5022.71±3 915.82) pg/ml]교비농독증조[(1 722.81±1 738.53) pg/ml]명현승고(P =0.001).다원선성회귀분석결과현시,PCIS화CRH시MIF적상관인소(t=-2.830,P=0.009;t=2.852,P=0.009).CRH월고,PCIS월저,MIF월고.결론 MIF일정정도상반영료혈액종류환인합병농독증시질병적엄중정도,MIF월고,PCIS월저,질병월엄중.MIF여농독증환인신상선피질공능존재일정련계.
Objective To assess the relationship between serum macrophage migration inhibitory factor (MIF) and sepsis in children with hematologic malignancy.Methods ( 1 ) An observational study was performed in a university pediatric intensive care unit.Forty-one children were enrolled in our study,and were divided into two groups:sepsis group (27 cases) and non sepsis group ( 14 cases).(2) Serum samples were taken in the both two groups in 24 h after they were admitted in hospital.Clinical and laboratory parameters,including the levels of serum MIF,cortisol,corticotropin releasing hormone ( CRH),and ferritin were measured and compared between the two groups.Multiple linear regression analysis was used to assess the relationship between MIF and CRH,cortisol and pediatric critical illness score (PCIS).Results The level of MIF was significantly elevated in the sepsis group[ (5 022.71 ± 3 915.82) pg/ml] than that of non sepsis group[ ( 1 722.81 ± 1 738.53) pg/ml] (P =0.001 ).Multiple linear regression analysis showed that CRH as well as PCIS were the correlative factors of MIF( t =- 2.830,P =0.009; t =2.852,P =0.009 ).The higher CRH concentration,the lower PCIS score,and the higher MIF was.Conclusion The level of serum MIF could reflect the severity of children with hematologic malignancy complicated with sepsis.The higher MIF concentration,the lower PCIS score,then the disease is more serious.To some extent,serum MIF is related with the adrenocortical function of sepsis children.