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[脓毒症患儿低蛋白血症与C反应蛋白及降钙素原的相关性]

[Correlation of hypoproteinemia with C-reactive protein and procalcitonin in children with sepsis].

作者信息

Fan Jiang-Hua, Zhu Yi-Min, Zhang Xin-Ping

机构信息

Pediatric Intensive Care Unit, Hunan Provincial Children's Hospital, Changsha 410007, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2010 Nov;12(11):870-3.

Abstract

OBJECTIVE

To investigate the correlation of hypoproteinemia with inflammation parameters C-reactive protein (CRP), procalcitonin (PCT) and WBC in children with sepsis.

METHODS

Seventy-three children with sepsis (including 22 severe sepsis) and 40 non-sepsis children (control group) were enrolled. Serum albumin levels were measured on admission. Based on the level of serum albumin, 73 cases of sepsis were classified into three groups: mild hypoproteinemia, severe hypoproteinemia and normal albumin. Blood CRP, PCT and WBC levels were compared in the three groups. The correlation of CRP, PCT and WBC with serum albumin level was evaluated.

RESULTS

Serum albumin levels in the sepsis groups (severe or non-severe) were significantly lower than those in the control group (P<0.05), and the severe sepsis group showed more decreased albumin levels compared with the non-severe sepsis group (P<0.05). Blood CRP, PCT and WBC levels in the mild hypoproteinemia group were higher than those in the normal albumin group (P<0.05), and the severe hypoproteinemia group showed more increased blood CRP, PCT and WBC levels compared with the mild hypoproteinemia group (P<0.05). The incidence of multiple organ failure in the severe hypoproteinemia group was significantly higher than that in the normal albumin group (P<0.05). Serum albumin levels were negatively correlated with blood CRP, PCT and WBC levels.

CONCLUSIONS

Serum albumin levels decrease in children with sepsis, and the more serious the illness, the lower serum albumin levels, resulting in a worse prognosis. CRP, PCT and WBC are negatively correlated to serum albumin levels in children with sepsis.

摘要

目的

探讨脓毒症患儿低蛋白血症与炎症指标C反应蛋白(CRP)、降钙素原(PCT)及白细胞(WBC)的相关性。

方法

纳入73例脓毒症患儿(包括22例严重脓毒症患儿)及40例非脓毒症患儿(对照组)。入院时测定血清白蛋白水平。根据血清白蛋白水平,将73例脓毒症患儿分为三组:轻度低蛋白血症组、重度低蛋白血症组和白蛋白正常组。比较三组患儿血液中CRP、PCT及WBC水平。评估CRP、PCT及WBC与血清白蛋白水平的相关性。

结果

脓毒症组(严重或非严重)血清白蛋白水平显著低于对照组(P<0.05),且严重脓毒症组白蛋白水平较非严重脓毒症组下降更明显(P<0.05)。轻度低蛋白血症组血液CRP、PCT及WBC水平高于白蛋白正常组(P<0.05),重度低蛋白血症组血液CRP、PCT及WBC水平较轻度低蛋白血症组升高更明显(P<0.05)。重度低蛋白血症组多器官功能衰竭发生率显著高于白蛋白正常组(P<0.05)。血清白蛋白水平与血液CRP、PCT及WBC水平呈负相关。

结论

脓毒症患儿血清白蛋白水平降低,病情越严重,血清白蛋白水平越低,预后越差。脓毒症患儿CRP、PCT及WBC与血清白蛋白水平呈负相关。

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