Briassoulis George, Mavrikiou Maria, Margeli Alexandra, Lazaropoulou Christina, Natsi Labrini, Papassotiriou Ioannis, Hatzis Tasos
Pediatric Intensive Care Unit, University Hospital of Heraklion, Crete, Hellas, Greece.
Pediatr Pulmonol. 2006 Aug;41(8):790-5. doi: 10.1002/ppul.20465.
KL-6 is a high molecular weight glycoprotein that is expressed on the apical borders of normal secretary alveolar epithelial cells. The aim of our study was to elucidate the potential role of circulating levels of KL-6, related to C-reacting protein (CRP), disease severity (PRISM, TISS), length of stay (LOS) or mechanical ventilation (LOMV), and outcome, in children with acute respiratory distress syndrome (ARDS), sepsis, or traumatic brain injury (TBI). KL-6 concentrations were monitored using solid phase sandwich enzyme-linked immunosorbent assay in plasma of nine patients with ARDS and compared to nine patients with TBI, nine with sepsis, and nine ventilated patients with cancer of matched illness severity on days 1, 3, 5, 7, and 10. Initial respiratory/ventilatory parameters (oxygenation index, plateau pressures) were recorded for ARDS patients. Patients with ARDS had higher early plasma levels of KL-6 (956 +/- 400 U/ml), as compared to patients with TBI (169 +/- 9 U/ml), sepsis (282 +/- 81 U/ml), and ventilated controls (255 +/- 40 U/ml). Significant correlations were demonstrated between plasma KL-6 concentration and oxygenation index, PaO(2): FiO(2) ratio, LOS and LOMV, but not with CRP or PRISM. Only in patients with ARDS, plasma KL-6 levels were higher in non-survivors than survivors (P < 0.03). Plasma KL-6 levels have possible prognostic significance and may provide a useful marker for ARDS in critically ill children.
KL-6是一种高分子量糖蛋白，在正常分泌性肺泡上皮细胞的顶端边界表达。我们研究的目的是阐明在急性呼吸窘迫综合征（ARDS）、脓毒症或创伤性脑损伤（TBI）患儿中，与C反应蛋白（CRP）、疾病严重程度（PRISM、TISS）、住院时间（LOS）或机械通气时间（LOMV）以及预后相关的循环KL-6水平的潜在作用。采用固相夹心酶联免疫吸附测定法监测9例ARDS患者血浆中的KL-6浓度，并与9例TBI患者、9例脓毒症患者以及9例病情严重程度匹配的癌症通气患者在第1、3、5、7和10天进行比较。记录ARDS患者的初始呼吸/通气参数（氧合指数、平台压）。与TBI患者（169±9 U/ml）、脓毒症患者（282±81 U/ml）和通气对照组（255±40 U/ml）相比，ARDS患者早期血浆KL-6水平更高（956±400 U/ml）。血浆KL-6浓度与氧合指数、PaO₂:FiO₂比值、LOS和LOMV之间存在显著相关性，但与CRP或PRISM无关。仅在ARDS患者中，非存活者的血浆KL-6水平高于存活者（P<0.03）。血浆KL-6水平可能具有预后意义，可为危重症儿童的ARDS提供有用的标志物。
