患有严重脓毒症和脓毒性休克儿童的铁蛋白水平。

Ferritin levels in children with severe sepsis and septic shock.

作者信息

Garcia Pedro Celiny Ramos, Longhi Fernanda, Branco Ricardo Garcia, Piva Jefferson Pedro, Lacks Dani, Tasker Robert Charles

机构信息

Pediatric Intensive Care Unit, Department of Pediatrics, Hospital São Lucas da PUCRS, and Medical School, Pontifica Universidade Catolica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

出版信息

Acta Paediatr. 2007 Dec;96(12):1829-31. doi: 10.1111/j.1651-2227.2007.00564.x.

DOI:10.1111/j.1651-2227.2007.00564.x

PMID:18001337

Abstract

AIM

To evaluate serum ferritin level in children with severe sepsis and septic shock and its association with mortality.

METHOD

A cohort study of 36 children aged 1 month-16 years with severe sepsis or septic shock requiring intensive care was conducted. Serum ferritin levels were measured at the time of diagnosis of sepsis and a ferritin index (FI=observed serum ferritin divided by the upper limit of normal ferritin for age and gender) was calculated.

RESULTS

The median age (range) of the children was 6 (2-100) months. Ferritin was <200 ng/mL in 13 children, 200-500 ng/mL in 11 children and >500 ng/mL in 12 children. The mortality associated with these groups was 23%, 9% and 58%, respectively. A ferritin>500 ng/mL was associated with a 3.2 (1.3-7.9) relative risk of death (p=0.01). FI of 1.7 was the best cutoff value for identifying those who died. In a logistic regression analysis, ferritin level and PRISM were independently associated with mortality.

CONCLUSIONS

Ferritin is raised in children with septic shock and high ferritin level is associated with poorer outcome.

摘要

目的

评估重症脓毒症和脓毒性休克患儿的血清铁蛋白水平及其与死亡率的关系。

方法

对36例年龄在1个月至16岁、患有重症脓毒症或脓毒性休克且需要重症监护的儿童进行队列研究。在脓毒症诊断时测量血清铁蛋白水平，并计算铁蛋白指数（FI = 观察到的血清铁蛋白除以年龄和性别的正常铁蛋白上限）。

结果

患儿的中位年龄（范围）为6（2 - 100）个月。13例儿童铁蛋白<200 ng/mL，11例儿童铁蛋白为200 - 500 ng/mL，12例儿童铁蛋白>500 ng/mL。这些组的死亡率分别为23%、9%和58%。铁蛋白>500 ng/mL与死亡相对风险3.2（1.3 - 7.9）相关（p = 0.01）。FI为1.7是识别死亡患儿的最佳临界值。在逻辑回归分析中，铁蛋白水平和PRISM与死亡率独立相关。