脓毒症患儿低蛋白血症与降钙素原的相关性研究

目的探讨脓毒症患儿低蛋白血症与降钙素原(procalcitonin,PCT)的相关性。方法将52例确诊为脓毒症的患儿分为严重脓毒症和非严重脓毒症组,并以同期非脓毒症患儿30例为对照组,测定血清白蛋白水平和炎症指标PCT。根据白蛋白水平将52例患儿分为轻度低蛋白血症组、重度低蛋白血症组和白蛋白正常组,比较3组PCT的变化,并对血清白蛋白的水平与PCT进行相关性分析。结果 52例脓毒症患儿白蛋白水平明显低于对照组,严重脓毒症组白蛋白水平低于非严重脓毒症组,差异均有统计学意义(P<0.05);轻、重度低蛋白血症组PCT均高于白蛋白正常组(分别P<0.05,P<0.01),而重度低蛋白组明显高于轻度低蛋白血症组(P<0.05)。重度低蛋白组多器官功能衰竭的发生率较白蛋白正常组增高(P<0.05),血清白蛋白水平与PCT呈负相关(r=-0.291,P<0.05)。结论脓毒症患儿白蛋白水平明显降低,白蛋白水平越低,病情越重,预后越差。血清白蛋白水平与反应脓毒症的炎症指标PCT呈负相关。

The correlation analysis of hypoproteinemia and procalcitonin in children with sepsis

Objective To investigate the relationship between hypoproteinemia and procalcitonin （PCT）, an inflammation in- dicator,in children with sepsis. Methods Fifty-two children with sepsis were divided into severe and non-severe sepsis groups. The levels of serum albumin and PCT were determined, and compared to 30 children without sepsis （ control group ）. Next, the 52 sepsis children were further divided into mild and severe hypoproteinemia, and normal albumin groups. The changes of PCT levels were com- pared among three groups. Meanwhile, the correlation between hypoproteinemia and PCT was also analyzed. Results Serum albumin concentrations in children with sepsis were significantly lower than that in control group （ P 〈 0.05 ）. The albumin concentrations in severe sepsis group were lower than that in non-severe sepsis group （ P 〈 0.05 ）. Serum PCT levels in mild and severe hypoproteinemia groups were higher than that in normal albumin group （P 〈 0.05 and 〈0.01, respectively）. The PCT levels were higher in severe hy- poproteinemia group than that in mild hypoproteinemia group （ P 〈 0.05 ）. The rate of multiple organ failure in severe hypoproteinemia group was higher than that in normal albumin group （P 〈 O. 05 ）. Serum albumin concentrations were negatively correlated with PCT levels （ r = -0. 291 ;P 〈 0.05 ）. Conclusions Serum albumin concentrations in children with sepsis were dramatically decreased. The serum albumin concentrations were lower, the states of illness were more severe, and the prognosis was poorer. Serum albumin concentra- tions were negatively correlated with PCT.