中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2013年
6期
603-605
,共3页
田杨%曾洁群%朱翠平%郑锐丹
田楊%曾潔群%硃翠平%鄭銳丹
전양%증길군%주취평%정예단
脓毒症%手术%生长激素%胰岛素样生长因子-Ⅰ%儿童
膿毒癥%手術%生長激素%胰島素樣生長因子-Ⅰ%兒童
농독증%수술%생장격소%이도소양생장인자-Ⅰ%인동
Sepsis%Surgery%Growth hormone%Insulin like growth factor-Ⅰ%Children
目的 探讨血清生长激素(growth hormone,GH)和胰岛素样生长因子-Ⅰ (insulin like growth factor-Ⅰ,IGF-Ⅰ)在危重症患儿中的变化及其临床意义.方法 选择2009年1月至2012年1月同期入住PICU的脓毒症患儿42例为脓毒症组,先天性心脏病择期在体外循环下行开胸手术治疗后的患儿20例为术后组,检测入院次日及手术后次日晨血清GH和IGF-Ⅰ水平,选择健康体检儿童60例为对照组,比较组间GH、IGF-Ⅰ水平的变化.结果 脓毒症组GH水平为(6.71±6.62) ng/ml,术后组GH水平为(8.86±8.06) ng/ml,,两者均显著高于对照组(3.87±3.31) ng/ml,差异有统计学意义(P＜0.05),而脓毒症组与术后组之间差异无统计学意义;脓毒症组IGF-Ⅰ水平为(63.72±54.17) ng/ml,与术后组(119.06±102.12) ng/ml和健康对照组(154.22±107.10) ng/ml比较,显著降低,差异有统计学意义(P＜0.05),术后组与对照组比较差异无统计学意义;脓毒症组内存活者与死亡者比较GH无统计学意义差异,IGF-Ⅰ水平显著降低(P＜0.05).结论 危重症时GH水平升高对机体应激具有积极作用;脓毒症时IGF-Ⅰ水平显著降低,可作为反映重症感染存在的较灵敏指标,并有助于判断预后.
目的 探討血清生長激素(growth hormone,GH)和胰島素樣生長因子-Ⅰ (insulin like growth factor-Ⅰ,IGF-Ⅰ)在危重癥患兒中的變化及其臨床意義.方法 選擇2009年1月至2012年1月同期入住PICU的膿毒癥患兒42例為膿毒癥組,先天性心髒病擇期在體外循環下行開胸手術治療後的患兒20例為術後組,檢測入院次日及手術後次日晨血清GH和IGF-Ⅰ水平,選擇健康體檢兒童60例為對照組,比較組間GH、IGF-Ⅰ水平的變化.結果 膿毒癥組GH水平為(6.71±6.62) ng/ml,術後組GH水平為(8.86±8.06) ng/ml,,兩者均顯著高于對照組(3.87±3.31) ng/ml,差異有統計學意義(P＜0.05),而膿毒癥組與術後組之間差異無統計學意義;膿毒癥組IGF-Ⅰ水平為(63.72±54.17) ng/ml,與術後組(119.06±102.12) ng/ml和健康對照組(154.22±107.10) ng/ml比較,顯著降低,差異有統計學意義(P＜0.05),術後組與對照組比較差異無統計學意義;膿毒癥組內存活者與死亡者比較GH無統計學意義差異,IGF-Ⅰ水平顯著降低(P＜0.05).結論 危重癥時GH水平升高對機體應激具有積極作用;膿毒癥時IGF-Ⅰ水平顯著降低,可作為反映重癥感染存在的較靈敏指標,併有助于判斷預後.
목적 탐토혈청생장격소(growth hormone,GH)화이도소양생장인자-Ⅰ (insulin like growth factor-Ⅰ,IGF-Ⅰ)재위중증환인중적변화급기림상의의.방법 선택2009년1월지2012년1월동기입주PICU적농독증환인42례위농독증조,선천성심장병택기재체외순배하행개흉수술치료후적환인20례위술후조,검측입원차일급수술후차일신혈청GH화IGF-Ⅰ수평,선택건강체검인동60례위대조조,비교조간GH、IGF-Ⅰ수평적변화.결과 농독증조GH수평위(6.71±6.62) ng/ml,술후조GH수평위(8.86±8.06) ng/ml,,량자균현저고우대조조(3.87±3.31) ng/ml,차이유통계학의의(P＜0.05),이농독증조여술후조지간차이무통계학의의;농독증조IGF-Ⅰ수평위(63.72±54.17) ng/ml,여술후조(119.06±102.12) ng/ml화건강대조조(154.22±107.10) ng/ml비교,현저강저,차이유통계학의의(P＜0.05),술후조여대조조비교차이무통계학의의;농독증조내존활자여사망자비교GH무통계학의의차이,IGF-Ⅰ수평현저강저(P＜0.05).결론 위중증시GH수평승고대궤체응격구유적겁작용;농독증시IGF-Ⅰ수평현저강저,가작위반영중증감염존재적교령민지표,병유조우판단예후.
Objective To explore the variation and clinical significance of growth hormone(GH) and insulin like growth factor-Ⅰ(IGF-Ⅰ) in children with critical disease.Methods One hundred and twenty-two cases were recruited into the study,among which 42 cases were sepsis in paediatric intensive care unit (sepsis group),20 cases had finished the cardiopulmonary bypass surgery without infection (surgery group).Sixty healthy children served as control group.Serum levels of GH and IGF-Ⅰ were deteced with immunochemiluminometric assay.Results The serum levels of GH were (6.71 ± 6.62) ng/ml in sepsis group,(8.86 ±8.06) ng/ml in surgery group,(3.87 ± 3.31) ng/ml in control group.Compared with the control group,the serum levels of GH in sepsis group and surgery group were increased significantly (P ＜ 0.05).There was no significant difference between sepsis group and surgery group.The serum IGF-Ⅰ levels were (63.72 ±54.17) ng/ml in sepsis group,(119.06 ± 102.12) ng/ml in surgery group and(154.22 ± 107.10) ng/ml in control group separately.The serum IGF-Ⅰ level of sepsis group was significantly decreased compared to the other two groups (P ＜ 0.05).There was no significant difference between surgery group and control group (P ＞0.05).In sepsis group,compared with those who died,the GH of the survival showed no significant difference,IGF-Ⅰ was significantly increased.(P ＜ 0.05).Conclusion GH playes a positive effect in patients with critical disease.IGF-Ⅰ decreases greatly in patients with serious infection.It suggests that IGF-Ⅰ could be a sensitive marker for reflecting whether there is serious infection.The sharply decreasing of IGF-Ⅰ may predict a bad outcome.
