CAJ | 학술논문

目的动态监测脓毒症、严重脓毒症患儿血清皮质醇、促肾上腺皮质激素( adrenocorticotropic hormone,ACTH)水平的变化,探讨其与临床的关系.方法以我院2010年9月至2011年1月收治的脓毒症患儿30例为研究对象,分为严重脓毒症组(10例)和脓毒症组(20例).在病程的急性期和恢复期分别检测血清皮质醇及ACTH水平,并与同期住院的10例非脓毒症患儿(对照组)进行对比分析.结果急性期严重脓毒症组血清皮质醇[( 33.97±6.83) μg/ml]明显高于脓毒症组[(26.30±10.43) μg/ml]和对照组[(19.06±6.91) μg/ml],差异有统计学意义(P＜0.01).急性期严重脓毒症组血清ACTH[ (25.47±9.41) pg/ml]明显高于脓毒症组[(15.52±5.85) pg/ml]和对照组[(9.16±3.02) pg/ml],差异有统计学意义(P＜0.01).结论脓毒症患儿发病早期机体存在应激反应,血清皮质醇、ACTH浓度明显升高;血清皮质醇、ACTH浓度升高的水平与病情严重程度有关,血清皮质醇、ACTH水平可作为评估患儿严重程度,判断预后的指标.
목적 동태감측농독증、엄중농독증환인혈청피질순、촉신상선피질격소( adrenocorticotropic hormone,ACTH)수평적변화,탐토기여림상적관계.방법 이아원2010년9월지2011년1월수치적농독증환인30례위연구대상,분위엄중농독증조(10례)화농독증조(20례).재병정적급성기화회복기분별검측혈청피질순급ACTH수평,병여동기주원적10례비농독증환인(대조조)진행대비분석.결과 급성기엄중농독증조혈청피질순[( 33.97±6.83) μg/ml]명현고우농독증조[(26.30±10.43) μg/ml]화대조조[(19.06±6.91) μg/ml],차이유통계학의의(P＜0.01).급성기엄중농독증조혈청ACTH[ (25.47±9.41) pg/ml]명현고우농독증조[(15.52±5.85) pg/ml]화대조조[(9.16±3.02) pg/ml],차이유통계학의의(P＜0.01).결론 농독증환인발병조기궤체존재응격반응,혈청피질순、ACTH농도명현승고;혈청피질순、ACTH농도승고적수평여병정엄중정도유관,혈청피질순、ACTH수평가작위평고환인엄중정도,판단예후적지표.
Objective To dynamic monitoring the changes of serum cortisol,adrenocorticotropic hormone (ACTH) in children with sepsis and servere sepsis,and to assess it's relationship with clinical features.Methods Thirty children with sepsis were enrolled in this study from Sep 2010 to Jan 2011 in our hospital,and were divided into severe sepsis group (n =10) and sepsis group (n =20).The serum cortisol and ACTH were analysed in acute and recovery period respectively in both two groups,and compared with 10 non-sepsis children as control group.Results In the acute period,the level of serum cortisol in severe sepsis group [ (33.97 ±6.83) μg/ml ] was significantly higher than those in sepsis group [ (26.30 ± 10.43) μg/ml]and control group [ ( 19.06 ± 6.91 ) μg/ml ] ( P ＜ 0.01 ) ; the level of serum ACTH in severe sepsis group [ (25.47 ± 9.41 ) pg/ml ] was significantly higher than those in sepsis group [ ( 15.52 ± 5.85 ) pg/ml ] and control group [ (9.16 ± 3.02 ) pg/ml ] ( P ＜ 0.01 ).Conclusion Stress response exists in the early period of sepsis,and the levels of serum cortisol and ACTH are increased significantly.The levels of serum cortisol and ACTH are positive correlation with the severity of diseases,and they could be used as serious index and a marker for evaluating prognosis in children with sepsis.