CAJ | 학술논문

目的：探讨脓毒症患儿血管内皮生长因子( vascular endothelial growth factor,VEGF)、E选择素、细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)和白细胞介素-6(interleukin-6, IL-6)的变化及临床意义。方法选择2008年12月至2009年12月入住我院PICU的脓毒症患儿32例,根据入院时是否出现休克分为休克组和无休克组,检测入院次日晨血清 IL-6、VEGF、E 选择素、ICAM-1水平,选择同期健康体检患儿15例为对照组,比较各组间IL-6、VEGF、E选择素、ICAM-1的变化。结果与对照组IL-6水平[M(P25~P75)][0．80(0．60~1．00) ng/L]相比,休克组IL-6水平[65．00(30．49~237．14) ng/L]和无休克组IL-6水平[48．68(30．25~75．00) ng/L]显著升高,差异有统计学意义(P<0．05),脓毒症两亚组间比较差异无统计学意义；休克组、无休克组、对照组三组间VEGF和E选择素水平比较差异无统计学意义；休克组ICAM-1水平[ M ( P25~P75)]为998．72(666．93~1526．44) ng/ml,无休克组ICAM-1水平为925．71(683．53~1225．12) ng/ml,与对照组660．59(525．48~685．47) ng/ml相比,差异有统计学意义(P<0．05),脓毒症两亚组间ICAM-1比较差异无统计学意义。脓毒症患儿死亡者与存活者比较, VEGF、E选择素无显著变化, IL-6、ICAM-1水平显著升高。结论 IL-6和ICAM-1在脓毒症时显著升高,有助于脓毒症的识别和预后判断。
목적：탐토농독증환인혈관내피생장인자( vascular endothelial growth factor,VEGF)、E선택소、세포간점부분자-1(intercellular adhesion molecule-1,ICAM-1)화백세포개소-6(interleukin-6, IL-6)적변화급림상의의。방법선택2008년12월지2009년12월입주아원PICU적농독증환인32례,근거입원시시부출현휴극분위휴극조화무휴극조,검측입원차일신혈청 IL-6、VEGF、E 선택소、ICAM-1수평,선택동기건강체검환인15례위대조조,비교각조간IL-6、VEGF、E선택소、ICAM-1적변화。결과여대조조IL-6수평[M(P25~P75)][0．80(0．60~1．00) ng/L]상비,휴극조IL-6수평[65．00(30．49~237．14) ng/L]화무휴극조IL-6수평[48．68(30．25~75．00) ng/L]현저승고,차이유통계학의의(P<0．05),농독증량아조간비교차이무통계학의의；휴극조、무휴극조、대조조삼조간VEGF화E선택소수평비교차이무통계학의의；휴극조ICAM-1수평[ M ( P25~P75)]위998．72(666．93~1526．44) ng/ml,무휴극조ICAM-1수평위925．71(683．53~1225．12) ng/ml,여대조조660．59(525．48~685．47) ng/ml상비,차이유통계학의의(P<0．05),농독증량아조간ICAM-1비교차이무통계학의의。농독증환인사망자여존활자비교, VEGF、E선택소무현저변화, IL-6、ICAM-1수평현저승고。결론 IL-6화ICAM-1재농독증시현저승고,유조우농독증적식별화예후판단。
Objective To investigate the variation of interleukin-6 ( IL-6 ) , vascular endothelial growth factor(VEGF),E-selectin and intercellular adhesion molecule-1(ICAM-1)in children with sepsis and the clinical significance. Methods This was a prospective and control study. Thirty-two children diagnosed as sepsis in PICU from December 2008 to December 2009 served as the sepsis group. According to whether there was a shock, sepsis group were divided into shock subgroup and no shock subgroup. Fifteen healthy children served as control group. The serum levels of IL-6,VEGF,E-selectin and ICAM-1 were detected with enzyme linked immunosorbent assay. Results The serum level of IL-6 was 65. 00(30. 49~237. 14) ng/L in shock subgroup and 48. 68(30. 25~75. 00) ng/L in no shock subgroup,which were significantly higher than that in control group[0. 80(0. 60 ~1. 00) ng/L](P<0. 05). There was no significant difference between shock subgroup and no shock subgroup. The serum levels of VEGF and E-selectin showed no significant differences among the three groups. The serum level of ICAM-1 was 998. 72(666. 93~1 526. 44) ng/ml in shock subgroup,and 925. 71(683. 53~1 225. 12) ng/ml in no shok subgroup,which were significantly high-er than that in control group[660. 59(525. 48~685. 47) ng/ml]. Compared with those who survived in sep-sis group,the serum levels of VEGF and E-selectin in the died children with sepsis showed no significant difference,but IL-6 and ICAM-1 significantly increased(P<0. 05). Conclusion IL-6 and ICAM-1 increase greatly and accentuate inflammation in septic patients,the changes of which may help to determine the prog-nosis of sepsis.