CAJ | 학술논문

目的探讨危重症患儿血清上皮来源中性粒细胞活化肽-78(ENA-78)的变化,及其与儿童危重症病情严重程度和预后的关系.方法采用前瞻性病例对照研究,选取2013年9月至11月上海交通大学附属儿童医院重症医学科收治的42例危重症患儿(危重症组),入院后24h内(急性期)和第7天(恢复期)留取血标本;选取本院同期42例儿童体检残血样本作为对照.采用儿童危重病例评分标准(PCIS)和儿童死亡危险因素评分(PRISMⅢ)评估病情的危重程度;双抗体夹心酶联免疫法测定血清中ENA-78水平.结果 1.对照组血液ENA-78水平为(0.44 ±0.28) ng/L;危重症组急性期ENA-78为(2.85±0.89) ng/L,恢复期为(1.00±0.64) ng/L,危重症组与对照组、急性期与恢复期ENA-78水平比较差异均有统计学意义(P均=0.000).2.ENA-78水平与PCIS评分呈负相关(r=-0.724,P=0.000);PRISMⅢ≥10分组血清ENA-78水平明显高于PRISMⅢ＜10分组(P =0.000).危重症患儿中,存活组ENA-78水平与死亡组比较差异有统计学意义(P=0.000).3.严重感染患儿血清ENA-78水平与非感染性疾病组比较差异有统计学意义(P =0.000).4.随着器官功能障碍损伤范围扩大ENA-78水平相应上升,差异有统计学意义(P =0.000).结论危重症患儿存在血液ENA-78水平的变化,测定血液中ENA-78水平,能对评估疾病严重程度及判断预后提供参考.
목적 탐토위중증환인혈청상피래원중성립세포활화태-78(ENA-78)적변화,급기여인동위중증병정엄중정도화예후적관계.방법 채용전첨성병례대조연구,선취2013년9월지11월상해교통대학부속인동의원중증의학과수치적42례위중증환인(위중증조),입원후24h내(급성기)화제7천(회복기)류취혈표본;선취본원동기42례인동체검잔혈양본작위대조.채용인동위중병례평분표준(PCIS)화인동사망위험인소평분(PRISMⅢ)평고병정적위중정도;쌍항체협심매련면역법측정혈청중ENA-78수평.결과 1.대조조혈액ENA-78수평위(0.44 ±0.28) ng/L;위중증조급성기ENA-78위(2.85±0.89) ng/L,회복기위(1.00±0.64) ng/L,위중증조여대조조、급성기여회복기ENA-78수평비교차이균유통계학의의(P균=0.000).2.ENA-78수평여PCIS평분정부상관(r=-0.724,P=0.000);PRISMⅢ≥10분조혈청ENA-78수평명현고우PRISMⅢ＜10분조(P =0.000).위중증환인중,존활조ENA-78수평여사망조비교차이유통계학의의(P=0.000).3.엄중감염환인혈청ENA-78수평여비감염성질병조비교차이유통계학의의(P =0.000).4.수착기관공능장애손상범위확대ENA-78수평상응상승,차이유통계학의의(P =0.000).결론 위중증환인존재혈액ENA-78수평적변화,측정혈액중ENA-78수평,능대평고질병엄중정도급판단예후제공삼고.
Objective To investigate the changes of epithelial neutrophil activating peptide-78 (ENA-78) in the serum of patients with critical illness,and to analyze the relationship between the severity and prognosis.Methods Prospective case-control study was performed,and 42 cases of critically ill patients admitted to Pediatric Intensive Care Unit,Children's Hospital Affiliated to Shanghai Jiaotong University from Sep.to Nov.2013 were selected as critically ill group,blood specimens were collected within 24 hours and 7 days after their admission.Another 42 cases of blood samples were collected during physical examinations in this hospital as control group.The severity of critically ill patients were graded by Pediatric Critical Illness Score (PICS) and Pediatric Risk of Score Mortality (PRISM) Ⅲ,and the serum ENA-78 was measured by double antibody sandwich enzyme-linked immunoassay.Results 1.The level of ENA-78 in the control group was (0.44 ± 0.28) ng/L; ENA-78 in acute phase and recovery phase of critically ill group were (2.85 ± 0.89)ng/L and (1.00 ± 0.64)ng/L,respectively,there were statistical differences between control group and critically ill group,acute phase group and recovery phase group (all P =0.000).2.The negative correlation was observed between ENA-78 concentration and PCIS score(r =-0.724,P =0.000).ENA-78 in PRISM Ⅲ ≥ 10 group was significantly higher than that in PRISM Ⅲ＜ 10 group(P =0.000).The ENA-78 between death group and the survival group was significantly different(P =0.000).3.ENA-78 in patients with severe infection was higher than that in the non-infectious cases(P =0.000).4.With the organ dysfunction expanded ENA-78 rose accordingly,and the difference was statistically significant (P =0.000).Conclusions The level of ENA-78 is different in critically ill patients in children.It can provide reference of assessing the severity of disease and predicting prognosis by determing the ENA-78 level.