Üzüm Özlem, Çağlar Aykut, Küme Tuncay, Sayıner Arzu, Er Anıl, Akgül Fatma, Ulusoy Emel, Yılmaz Durgül, Duman Murat
Department of Pediatrics, and Departments of Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Division of Pediatric Emergency Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Turk J Pediatr. 2017;59(3):281-287. doi: 10.24953/turkjped.2017.03.008.
Üzüm Ö, Çağlar A, Küme T, Sayıner A, Er A, Akgül F, Ulusoy E, Yılmaz D, Duman M. Are cytokines and cortisol important predictors for the severity of pediatric croup: A case control study. Turk J Pediatr 2017; 59: 281-287. The aim of this study is to investigate the role of cytokines (TNF-α, IL-6, IL-10, and PAF), cortisol, and IgE in the pathogenesis of croup and the factors determining its clinical severity. Patients diagnosed with croup at the Pediatric Emergency Department were included and thirty healthy children were included as a control group. Patients` demographic characteristics, clinical findings, recurrent croup history, and patient-family atopy history were recorded. Patients were grouped according to the Westley croup scoring system. Blood samples were taken from the control group and the patients for cytokines and cortisol. Respiratory pathogens were studied with PCR. Sixty-nine pediatric cases who were diagnosed as croup were included in the study (34 mild, 31 moderate, 4 severe). Group comparisons were made in terms of mild and moderate/severe groups. In the moderate/severe group, IL-10 and cortisol levels were higher than the mild group. The moderate/severe cortisol levels between 12:00 am-6:00 pm were found to be higher. PAF and TNF-alpha levels were detected to be higher in patients with a history of atopy. Viral agents were isolated in 45 patients; rhinovirus PCR tests were positive in 22 patients. In this study, rhinovirus was the most common etiology for croup. Increased levels of IL-10 and cortisol in the moderate/severe group indicate that different systemic and local mechanisms may play a role in the pathogenesis of croup.
厄兹姆·Ö、恰拉尔·A、库梅·T、萨伊纳·A、埃尔·A、阿克居尔·F、乌鲁索伊·E、伊尔马兹·D、杜曼·M。细胞因子和皮质醇是小儿喉炎严重程度的重要预测指标吗：一项病例对照研究。《土耳其儿科学杂志》2017年；59：281 - 287。本研究的目的是探讨细胞因子（肿瘤坏死因子-α、白细胞介素-6、白细胞介素-10和血小板活化因子）、皮质醇和免疫球蛋白E在喉炎发病机制中的作用以及决定其临床严重程度的因素。纳入在儿科急诊科诊断为喉炎的患者，并纳入30名健康儿童作为对照组。记录患者的人口统计学特征、临床表现、复发性喉炎病史以及患者-家族过敏史。根据韦斯特利喉炎评分系统对患者进行分组。从对照组和患者中采集血液样本检测细胞因子和皮质醇。采用聚合酶链反应研究呼吸道病原体。69例诊断为喉炎的儿科病例纳入研究（轻度34例、中度31例、重度4例）。对轻度组和中度/重度组进行组间比较。在中度/重度组中，白细胞介素-10和皮质醇水平高于轻度组。发现凌晨12点至下午6点之间中度/重度皮质醇水平更高。有过敏史患者的血小板活化因子和肿瘤坏死因子-α水平检测更高。45例患者分离出病毒病原体；22例患者鼻病毒聚合酶链反应检测呈阳性。在本研究中，鼻病毒是喉炎最常见的病因。中度/重度组中白细胞介素-10和皮质醇水平升高表明不同的全身和局部机制可能在喉炎发病机制中起作用。
