CAJ | 학술논문

目的本研究通过测定促炎和抗炎两方面的代表性细胞因子——白细胞介素( interleukin,IL)-6和IL-10,判断小儿肺炎相关脓毒症的炎症反应水平及其在病程中的变化.方法将2008年9月至2009年3月收入PICU的62例肺炎患儿分为肺炎组(n=31)、脓毒症组(n=20)、严重脓毒症组(n=11),分别测定人PICU第1天和第4天的血清IL-6和IL-10水平.结果严重脓毒症组患儿的小儿死亡危险评分Ⅲ及病死率显著高于肺炎组和脓毒症组,差异有统计学意义(P＜0.05).肺炎组、脓毒症组、严重脓毒症组患儿在入PICU第1天的血清IL-6水平依次递增,分别为(55.68±61.41) pg/ml、(57.46±96.56) pg/ml及(114.86±206.37) pg/ml,但差异不具有统计学意义(P ＞0.05)；IL-10水平则依次递减,分别为(59.50±57.97) pg/ml、(41.27±28.37) pg/ml及(20.05±9.14) pg/ml,差异具有统计学意义(P＜0.05)；IL-6/IL-10分别为1.51 ±2.42、1.48 ±2.50、14.47±26.97,差异具有统计学意义(P＜0.05).入PICU第4天3组患儿血清IL-6、IL-10及IL-6/IL-10的差异均没有统计学意义(P＞0.05).结论血清IL-10水平可能有助于评估儿童肺炎相关脓毒症的严重程度,IL-6/IL-10升高提示预后不良.
목적 본연구통과측정촉염화항염량방면적대표성세포인자——백세포개소( interleukin,IL)-6화IL-10,판단소인폐염상관농독증적염증반응수평급기재병정중적변화.방법 장2008년9월지2009년3월수입PICU적62례폐염환인분위폐염조(n=31)、농독증조(n=20)、엄중농독증조(n=11),분별측정인PICU제1천화제4천적혈청IL-6화IL-10수평.결과 엄중농독증조환인적소인사망위험평분Ⅲ급병사솔현저고우폐염조화농독증조,차이유통계학의의(P＜0.05).폐염조、농독증조、엄중농독증조환인재입PICU제1천적혈청IL-6수평의차체증,분별위(55.68±61.41) pg/ml、(57.46±96.56) pg/ml급(114.86±206.37) pg/ml,단차이불구유통계학의의(P ＞0.05)；IL-10수평칙의차체감,분별위(59.50±57.97) pg/ml、(41.27±28.37) pg/ml급(20.05±9.14) pg/ml,차이구유통계학의의(P＜0.05)；IL-6/IL-10분별위1.51 ±2.42、1.48 ±2.50、14.47±26.97,차이구유통계학의의(P＜0.05).입PICU제4천3조환인혈청IL-6、IL-10급IL-6/IL-10적차이균몰유통계학의의(P＞0.05).결론 혈청IL-10수평가능유조우평고인동폐염상관농독증적엄중정도,IL-6/IL-10승고제시예후불량.
Objective To determine the changes of the host's inflammatory response throughout the course of sepsis secondary to pneumonia by evaluating the serum levels of interleukin (IL)-6 and IL-10.Methods Sixty-two patients who were diagnosed with pneumonia and hospitalized in PICU from Sep 2008 to Mar 2009 were enrolled in this study.They were divided into 3 groups:pneumonia group (n =31 ),sepsis group (n =20) and severe sepsis group (n =11 ).The serum levels of IL-6 and Il-10 were measured by enzyme-linked immunosorbent assay at the day 1 and day 4 after admitted to PICU.Results The pediatric risk of score mortality Ⅲ scores and fatality rate were significantly higher in severe sepsis group compared to the other two groups (P ＜ 0.05).The levels of IL-6 were (55.68 ± 61.41 ) pg/ml,(57.46 ± 96.56) pg/ml,and ( 114.86 ± 206.37) pg/ml in pneumonia group,sepsis group and severe sepsis group at day 1 of PICU,with no difference among 3 groups.However,the levels of IL-10 were ( 59.50 ± 57.97 ) pg/ml,( 41.27 ±28.37) pg/ml,and(20.05 ±9.14) pg/ml at day 1 in 3 groups,which showed a significant difference(P ＜0.05).The ratio of IL-6 to IL-10 were 1.51 ±2.42,1.48 ±2.50,and 14.47 ±26.97 at day 1 in 3 groups.There was a significant differrence among 3 groups ( P ＜ 0.05 ).No difference was found among 3 groups at day 4.Conclusion IL-10 may be an determinant factor of the severity and prognosis of the sepsis,and measurement of IL-10 or the ratio of IL-6 to IL-10 can be used to evaluate the severity and prognosis of sepsis.