Inwald David, Peters Mark
Paediatric Intensive Care Unit, St Mary's Hospital, London UK.
Crit Care. 2006;10(2):129. doi: 10.1186/cc4873.
In the previous issue of Critical Care, Vermont and colleagues presented a simple but well-executed observational study describing the levels of chemokines in the serum of 58 children with meningococcal sepsis. The chemokine levels correlated with disease severity and outcome. Significant correlations were demonstrated between admission chemokine levels and the Paediatric Risk of Mortality score, the Disseminated Intravascular Coagulopathy score, the Sequential Organ Failure Assessment score and laboratory parameters of disease severity. Additionally, nonsurvivors had much higher levels of chemokines compared with survivors, and the chemokine levels predicted mortality with a high degree of sensitivity and specificity. The findings are important as they indicate a possible mechanism for risk stratification in future trials of novel therapies in human sepsis, which as yet have not been successful.
在上一期的《重症监护》杂志中，佛蒙特及其同事发表了一项简单但执行良好的观察性研究，描述了58名患有脑膜炎球菌败血症儿童血清中的趋化因子水平。趋化因子水平与疾病严重程度及预后相关。入院时趋化因子水平与儿科死亡风险评分、弥散性血管内凝血评分、序贯器官衰竭评估评分以及疾病严重程度的实验室参数之间存在显著相关性。此外，与幸存者相比，非幸存者的趋化因子水平要高得多，且趋化因子水平以高度的敏感性和特异性预测死亡率。这些发现很重要，因为它们指出了在人类败血症新型疗法的未来试验中进行风险分层的一种可能机制，而这些试验目前尚未成功。
