关键词: 脓毒症, 弥漫性血管内凝血, 细胞因子类

Abstract: Objective To evaluate the correlation of inflammatory cytokine levels and main indexes reflecting coagulation function in children with sepsis. 
Methods A total of 80 children with severe sepsis/septic shock were enrolled retrospectively and then divided into two groups based on Chinese disseminated intravascular coagulation(DIC) score: DIC group and non-DIC group. The basic information, routine blood test, C-reactive protein(CRP), procalcitonin(PCT) and inflammation cytokines ［interleukin(IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α(TNF-α), interferon-γ(IFN-γ)］, coagulation tests ［prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), fibrinogen(FIB), D-dimer(DD)］ and thrombelastogram(TEG) in both groups were collected. The correlation between cytokines and CDSS score, four items of blood coagulation, DD and TEG was analyzed. 
Results The white blood cells in DIC group were lower while CRP and IL-6 were significantly higher than those in non-DIC group(P＜0.05). There were no significant differences in gender, age, absolute lymphoid value, PCT, IL-2, IL-4, IL-10, TNF-α and IFN-γ between two groups(P＞0.05). PT, APTT, international normalized ratio(INR), TT, DD and R value in DIC group were higher, while FIB, Angle, MA value and CI value in  DIC group were lower, as compared with those in non-DIC group(P＜0.05). Correlation analysis showed that CDSS score was positively correlated with IL-6, CRP, PCT, R value, PT, INR, APTT, and DD, and negatively correlated with MA value, CI value and FIB(P＜0.05). Also, PCT was positively correlated with APTT, and CRP was positively correlated with R value(P＜0.05). 
Conclusion There is correlation between CDSS with TEG, four items of blood coagulation and inflammatory indexes in children with sepsis, and IL-6 showed a strongest correlation with CDSS, which may be one of the potential mechanisms for the occurrence and development of DIC. 

Key words: sepsis, disseminated intravascular coagulation, Cytokine