小儿脓毒血症血清NT-proBNP、CRP、IL-10及TNF-α水平变化及其与预后的关系

doi:10.3969/j.issn.1007-3205.2020.05.006

河北医科大学学报

小儿脓毒血症血清NT-proBNP、CRP、IL-10及TNF-α水平变化及其与预后的关系

河北北方学院附属第一医院小儿内科，河北张家口 075000

出版日期:2020-05-25 发布日期:2020-06-04
作者简介:邢静（1981-），女，内蒙古化德人，河北北方学院附属第一医院主治医师，医学硕士，从事小儿肾脏疾病诊治研究。
基金资助:
河北省医学科学研究课题计划(20200503);张家口市科学技术研究与发展计划(1921055D)；河北省医学科学研究课题计划（20200503）

Changes of serum NT-proBNP, CRP, IL-10 and TNF-α levels in children with sepsis and their relationship with prognosis#br#

Department of Pediatric Internal Medicine, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China

Online:2020-05-25 Published:2020-06-04

摘要/Abstract

摘要： ［摘要］
目的分析小儿脓毒血症血清氨基末端脑钠肽前体（N-terminal pro-brain natriuretic peptide,NT-proBNP）、C反应蛋白（C-reactive protein,CRP）、白细胞介素10（interleukin-10,IL-10）及肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）水平变化及其与预后的关系。
方法选取脓毒症患儿80例（观察组）及同期健康体检儿童30例（对照组），比较2组入院5 d内血清NT-proBNP、CRP、IL-10及TNF-α水平，分析不同病情脓毒症患儿上述指标，依据脓毒症患儿28 d预后情况将其分为预后良好组、预后不良组，对比其入院5 d内平均血清NT-proBNP、CRP、IL-10及TNF-α水平，分析NT-proBNP、CRP、IL-10及TNF-α水平对小儿脓毒症死亡的预测价值。
结果观察组入院第1 天至第5 天血清NT-proBNP、CRP及TNF-α水平呈先升高后降低趋势，而IL-10呈先降低后升高趋势，且观察组第1 d血清NT-proBNP、CRP及TNF-α水平高于对照组，而IL-10水平低于对照组（P＜0.05）；脓毒症休克患儿入院5 d内平均NT-proBNP、CRP及TNF-α高于一般脓毒症、严重脓毒症患儿，而IL-10低于一般脓毒症、严重脓毒症患儿（P＜0.05）；预后良好组入院5 d内平均NT-proBNP、CRP及TNF-α水平低于预后不良组，而IL-10高于预后不良组（P＜0.05）；NT-proBNP预测脓毒症患儿死亡的ROC曲线下面积为0868，大于CRP、IL-10及TNF-α。
结论脓毒症患儿入院5 d内NT-proBNP、CRP、IL-10及TNF-α水平发生明显变化，且与预后有密切关系，应加以监测。

关键词: 脓毒症, 脑利钠肽, C反应蛋白质

Abstract: ［Abstract］ Objective〖HTSS〗To analyze the changes of serum N-terminal pro-brain natriureticpeptide(NT-proBNP), C-reactive protein(CRP), interleukin-10(IL-10) and tumor necrosis factor-α(TNF-α) in children with sepsisand their relationship with prognosis.
〖WTHZ〗Methods〖HTSS〗Eighty children with sepsis(observation group) and 30 healthy children(control group) were enrolled in the study. Levels of serum NT-proBNP, CRP, IL-10 and TNF-α were compared between two groups within 5 days after admission. Above indicators in children with sepsis in different conditions were analyzed. According to the 28-dayprognosis of children with sepsis, they were divided into the good prognosis group and the poor prognosis group. Levels of serum NT-proBNP, CRP, IL-10 and TNF-α were compared between two groups within 5 days after admission. The predictive value of NT-proBNP, CRP, IL-10 and TNF-α levels for death of children with sepsis was analyzed.
〖WTHZ〗Results〖HTSS〗The serum levels of NT proBNP, CRP and TNF-α in the observation group increased first and then decreased from the first day to the fifth day after admission, while the serum levels of NT proBNP, CRP and TNF-α in the observation group were higher than those in the control group, while the serum levels of IL-10 were lower than those in the control group(P＜0.05). The mean NT proBNP, CRP and TNF-α of septic shock children were higher than those of general sepsis and severe sepsis children in 5 days after admission, while IL-10 was lower than those of general sepsis and severe sepsis children(P＜0.05). The average levels of NT proBNP, CRP and TNF-α in the patients with good prognosis were lower than those in the patients with poor prognosis, while IL-10 was higher than those in the patients with poor prognosis(P＜0.05). The area under ROC curve predicted by NT proBNP was 0.868, which was larger than that of CRP, IL-10 and TNF-α.
〖WTHZ〗Conclusion〖HTSS〗The levels of NT proBNP, CRP, IL-10 and TNF-α in children with sepsis were significantly changed within 5 days after admission, and they were closely related to the prognosis and should be monitored.

Key words: sepsis, brain natriuretic peptide, C-reactive protein

邢静，卢艳辉，王艳飞，李晓娟，王瑞娟，孙喜斌. 小儿脓毒血症血清NT-proBNP、CRP、IL-10及TNF-α水平变化及其与预后的关系[J]. 河北医科大学学报, doi: 10.3969/j.issn.1007-3205.2020.05.006.

XING Jing, LU Yan-hui, WANG Yan-fei, LI Xiao-juan, WANG Rui-juan, SUN Xi-bin. Changes of serum NT-proBNP, CRP, IL-10 and TNF-α levels in children with sepsis and their relationship with prognosis#br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.1007-3205.2020.05.006.

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小儿脓毒血症血清NT-proBNP、CRP、IL-10及TNF-α水平变化及其与预后的关系

Changes of serum NT-proBNP, CRP, IL-10 and TNF-α levels in children with sepsis and their relationship with prognosis#br#

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