摘要
目的回顾性比较脓毒症与非脓毒症危重患儿非甲状腺疾病综合征(NTIS)的发生率,并初步探讨其发生与白细胞介素(IL)-6、IL-10的关系。方法回顾性收集97例脓毒症患儿(脓毒症组)和80例细菌感染相关非脓毒症危重患儿(非脓毒症组)的基本资料及甲状腺功能检测结果进行分析研究,并将IL-6、IL-10与甲状腺功能指标三碘酪氨酸(T3)、四碘络氨酸(T4)、促甲状腺激素(TSH)进行相关性分析。结果脓毒症与非脓毒症组年龄、性别比较差异无统计学意义(P>0.05)。脓毒症组序贯器官衰竭评分、住院时间、呼吸机使用率等均高于非脓毒症组(P<0.05)。脓毒症组炎症指标C反应蛋白(CRP)、降钙素原(PCT)、IL-6水平均显著高于非脓毒症组(P<0.05)。脓毒症组甲状腺功能指标T3、T4、游离T3、游离T4、TSH水平均显著低于非脓毒症组(P<0.05)。脓毒症组NTIS发生率、低T3低T4及低TSH发生率均显著高于非脓毒症组(P<0.001)。相关分析发现脓毒症和非脓毒症患儿IL-6水平与T3、T4、TSH水平均无相关性(P>0.05),但两组患儿合并分析显示,IL-6水平与T3、T4水平均存在负相关关系(P<0.001)。结论脓毒症患儿相比非脓毒症危重患儿更容易合并NTIS,且高水平IL-6可能是造成NTIS发生的重要原因。[中国当代儿科杂志,2020,22(11):1215-1220]
Objective To study the incidence rate of non-thyroidal illness syndrome(NTIS)in critically ill children with or without sepsis and the association of NTIS with interleukin-6(IL-6)and interleukin-10(IL-10).Methods A retrospective analysis was performed on the medical data of 97 children with sepsis(sepsis group)and 80 non-sepsis children with bacterial infection(non-sepsis group).The correlations of IL-6 and IL-10 with the thyroid function parameters triiodothyronine(T3),thyroxine(T4),and thyroid stimulating hormone(TSH)were analyzed.Results There were no significant differences in age and sex between the sepsis and non-sepsis groups(P>0.05).Compared with the non-sepsis group,the sepsis group had a significantly higher Sequential Organ Failure Assessment score,a significantly longer length of hospital stay,and a significantly higher rate of use of ventilator(P<0.05).As for inflammation markers,the sepsis group had significantly higher levels of C-reactive protein,procalcitonin,and IL-6 than the non-sepsis group(P<0.05).As for thyroid function parameters,the sepsis group had significantly lower levels of T3,T4,free T3,free T4,and TSH than the non-sepsis group(P<0.05).Compared with the non-sepsis group,the sepsis group had significantly higher incidence rates of NTIS,low T3 and T4,and low TSH(P<0.001).The correlation analysis revealed that IL-6 level was not correlated with T3,T4,and TSH levels in children with or without sepsis(P>0.05),but the pooled analysis of the two groups showed that IL-6 level was negatively correlated with T3 and T4 levels(P<0.001).Conclusions Children with sepsis have a higher incidence rate of NTIS than those without sepsis.The high level of IL-6 may be associated with the development of NTIS.[Chin J Contemp Pediatr,2020,22(11):1215-1220]
作者
徐梅先
刘刚
曹利静
白新凤
康磊
赵欣
石晓娜
李丽景
XU Mei-Xian;LIU Gang;CAO Li-Jing;BAI Xin-Feng;KANG Lei;ZHAO Xin;SHI Xiao-Na;LI Li-Jing(Pediatric Intensive Care Unit,Hebei Children's Hospital,Shijiazhuang 050000,China)
出处
《中国当代儿科杂志》
CAS
CSCD
北大核心
2020年第11期1215-1220,共6页
Chinese Journal of Contemporary Pediatrics
基金
河北省重点研发计划(182777133)。
