Kendirli Tanil, Ince Erdal, Ciftci Ergin, Doğru Ulker, Eğin Yonca, Akar Nejat
Pediatric Intensive Care Unit, Ankara University School of Medicine, Ankara, Turkey.
Pediatr Hematol Oncol. 2009 Sep;26(6):432-8. doi: 10.3109/08880010903044870.
Endothelial protein C receptor (EPCR) is primarily localized on the endothelial cells of large blood vessels. EPCR enhances activation of protein C by 5- to 20-fold. EPCR appears to be physiologically significant in the control of blood coagulation and inflammation and in the host response to gram-negative sepsis. In this study, the authors evaluated serum-soluble EPCR level in septic children in a pediatric intensive care unit (PICU) in a university hospital. The study was performed between March 2006 and September 2007 and consisted of 39 patients with sepsis and 40 healthy children. Septic patients were enrolled consecutively. Serum-soluble EPCR level was determined by enzyme-linked immunosorbent assay. The ages of the children with sepsis and those in the control groups ranged between 59 +/- 68 and 68 +/- 52 months, respectively. The serum sEPCR levels of septic children and those in control groups were 87 (38-260) and 72 (42-180) ng/mL (p > .05), respectively. The mortality rate was 25.6% in our patients. Escherichia coli and Klebsiella pneumonia were the most common pathogens. Among these children 16 had sepsis, 23 had septic shock, 15 had multiple organ dysfuntion syndrome, and 12 had disseminated intravascular coagulation. sEPCR levels of survivors were 96 (44-260) and those of nonsurvivors' were 82.5 (38-325) ng/mL (p > .05). Serum soluble endothelial protein C receptor level is not elevated in children with sepsis, and it is not a prognostic parameter in septic children.
内皮蛋白C受体（EPCR）主要定位于大血管的内皮细胞。EPCR可使蛋白C的活化增强5至20倍。EPCR在血液凝固和炎症的控制以及宿主对革兰氏阴性脓毒症的反应中似乎具有重要的生理意义。在本研究中，作者评估了一所大学医院儿科重症监护病房（PICU）中脓毒症患儿的血清可溶性EPCR水平。该研究于2006年3月至2007年9月进行，包括39例脓毒症患者和40例健康儿童。脓毒症患者连续入选。血清可溶性EPCR水平通过酶联免疫吸附测定法测定。脓毒症患儿和对照组儿童的年龄分别在59±68个月和68±52个月之间。脓毒症患儿和对照组儿童的血清可溶性EPCR水平分别为87（38 - 260）和72（42 - 180）ng/mL（p>.05）。我们的患者死亡率为25.6%。大肠杆菌和肺炎克雷伯菌是最常见的病原体。在这些儿童中，16例患有脓毒症，23例患有脓毒性休克，15例患有多器官功能障碍综合征，12例患有弥散性血管内凝血。幸存者的可溶性EPCR水平为96（44 - 260），非幸存者的为82.5（38 - 325）ng/mL（p>.05）。脓毒症患儿的血清可溶性内皮蛋白C受体水平未升高，且它不是脓毒症患儿的预后参数。
