脓毒症和脓毒性休克患儿的白细胞介素-6与降钙素原

Interleukin-6 and procalcitonin in children with sepsis and septic shock.

作者信息

Fioretto José R, Martin Joelma G, Kurokawa Cilmery S, Carpi Mário F, Bonatto Rossano C, Ricchetti Sandra M Q, de Moraes Marcos A, Padovani Carlos R

机构信息

Pediatric Intensive Care Unit, Pediatrics Department, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil.

出版信息

Cytokine. 2008 Aug;43(2):160-4. doi: 10.1016/j.cyto.2008.05.005. Epub 2008 Jun 18.

DOI:10.1016/j.cyto.2008.05.005

PMID:18565757

Abstract

OBJECTIVES

To examine the behavior of interleukin-6 (IL-6) and procalcitonin (PCT) and verify whether they can be used to differentiate children with septic conditions.

METHODS

Septic children aged between 28 days and 14 years, prospectively enrolled from 01/2004 to 12/2005, were divided into sepsis (SG; n=47) and septic shock (SSG; n=43) groups. IL-6 and PCT were measured at admission (T0) and 12h later (T12h). PCT results were classed as: 0.5 ng/mL=sepsis unlikely; > or =0.5 to <2=sepsis possible; > or =2 to <10=systemic inflammation; > or =10=septic shock.

RESULTS

Ninety children were included. At T0, there was a higher frequency of SSG with higher PCT compared with SG [SSG: 30 (69.7%)>SG: 14 (29.8%); p<0.05]. Similar results were observed at T12h. PRISM was significantly higher for SSG patients with higher PCT than SG patients. At T0, IL-6 levels were higher in SSG [SSG: 213.10 (10.85-396.70)>SG: 63.21 (0.86-409.82); p=0.001], but not statistically different at T12h. IL-6 levels positively correlated with PRISM score in SSG patients at admission (p=0.001; r=0.86).

CONCLUSION

PCT and IL-6 appear to be helpful in early assessment of pediatric sepsis, are of diagnostic value at admission, and are related to disease severity.

摘要

目的

研究白细胞介素-6（IL-6）和降钙素原（PCT）的变化情况，并验证它们是否可用于鉴别患有脓毒症的儿童。

方法

前瞻性纳入2004年1月至2005年12月期间年龄在28天至14岁之间的脓毒症儿童，分为脓毒症组（SG；n = 47）和脓毒性休克组（SSG；n = 43）。在入院时（T0）和12小时后（T12h）检测IL-6和PCT。PCT结果分类如下：<0.5 ng/mL = 不太可能是脓毒症；≥0.5至<2 = 可能是脓毒症；≥2至<10 = 全身炎症；≥10 = 脓毒性休克。

结果

共纳入90名儿童。在T0时，与SG组相比，PCT较高的SSG组频率更高[SSG组：30例（69.7%）>SG组：14例（29.8%）；p<0.05]。在T12h时观察到类似结果。PCT较高的SSG组患者的PRISM评分显著高于SG组患者。在T0时，SSG组的IL-6水平较高[SSG组：213.10（10.85 - 396.70）>SG组：63.21（0.86 - 409.82）；p = 0.001]，但在T12h时无统计学差异。入院时SSG组患者的IL-6水平与PRISM评分呈正相关（p = 0.001；r = 0.86）。