摘要
目的探讨PICU中葡萄糖-6-磷酸脱氢酶(G6PD)缺陷对急性感染患儿血清炎症细胞因子水平动态变化影响及其与病情和预后的关系。方法选取2014年6月至2017年12月入住广西壮族自治区妇幼保健院PICU的急性重症感染患儿160例作为研究对象,包括80例G6PD缺陷患儿(观察组)及80例无G6PD缺陷患儿(对照组),对两组患儿入科时、治疗12 h及24 h血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-10、C-反应蛋白(CRP)等炎症细胞因子水平变化进行监测,同时对其脓毒症、多器官功能障碍综合征(MODS)发生及预后情况进行前瞻性研究。结果观察组较对照组在入科时血清细胞因子和CRP水平明显增高[TNF-α:(65.57±19.09)pg/ml比(46.53±20.34)pg/ml;IL-6:(98.90±29.02)pg/ml比(89.89±25.54)pg/ml;IL-10:(87.66±21.84)pg/ml比(76.34±19.01)pg/ml;CRP:(60.18±22.24)mg/L比(41.43±19.51)mg/L],差异均有统计学意义(P均<0.05)。治疗后12 h及24 h观察组细胞因子及CRP水平均高于对照组,差异均有统计学意义(P均<0.01)。与对照组比较,观察组患儿脓毒症(82.50%比67.50%)、MODS(73.75%比58.75%)发生率增高,治愈好转率(81.25%比92.50%)下降,差异均有统计学意义(P均<0.05)。结论G6PD缺陷儿童急性感染时更需要警惕炎症反应、脓毒症、MODS发生,治疗难度增加,其机制可能与氧化应激有关。
Objective To explore the serum levels of inflammatory cytokines and prognosis in severe acute infection children with glucose-6-phosphate dehydrogenase(G6PD)deficiency.Methods A total number of 160 children with severe acute infections admitted to PICU of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital from June 2014 to December 2017 were selected as subjects in this study,including 80 children with G6PD deficiency(observation group)and 80 children without G6PD deficiency(control group).The changes of TNF-α,IL-6,IL-10 and CRP were dynamically monitored at 0-hour,12-hour and 24-hour after admision,and the occurrences of sepsis,multiple organ dysfunction syndrome(MODS)were prospectively analyzed.Results The levels of serum cytokines and CRP in the observation group were significantly higher than those in the control group at admission[TNF-α:(65.57±19.09)pg/ml vs.(46.53±20.34)pg/ml;IL-6:(98.90±29.02)pg/ml vs.(89.89±25.54)pg/ml;IL-10:(87.66±21.84)pg/ml vs.(76.34±19.01)pg/ml;CRP:(60.18±22.24)mg/L vs.(41.43±19.51)mg/L,respectively],and the differences between two groups were statistically significant(P<0.05).The levels of cytokines and CRP in the observation group were higher than those in the control group at 12 h and 24 h after treatment(P<0.01).Compared with the control group,the incidences of sepsis(82.50%vs 67.50%)and MODS(73.75%vs 58.75%)in the observation group increased,and the recovery rate(81.25%vs 92.50%)decreased,with statistical significance between two groups(P<0.05).Conclusion Children with G6PD deficiency need to be paid more attention to inflammation,sepsis,MODS and the difficulty of treatment when they are infected.The potential mechanism may be related to oxidative stress.
作者
莫武桂
唐育鹏
韦蓉
谢友军
黄维真
付君
卢功志
莫致荣
郑劼
Mo Wugui;Tang Yupeng;Wei Rong;Xie Youjun;Huang Weizhen;Fu Jun;Lu Gongzhi;Mo Zhirong;Zheng Jie(Department of Intensive Care Unit,Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital,Nanning 530003,China;Clinical Laboratory,Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital,Nanning 530003,China)
出处
《中国小儿急救医学》
CAS
2020年第6期469-472,共4页
Chinese Pediatric Emergency Medicine
基金
广西医疗卫生适宜技术与开发课题(S201405-04)。
