血管生成素在脓毒症相关性肺损伤患儿血清中的变化及其临床意义

目的 探讨血管生成素1、2（Angl、Ang2）在脓毒症患儿血清中的变化及其临床意义。方法 以57例脓毒症患儿为研究对象进行前瞻性临床研究。根据诊断标准及病情严重程度将脓毒症患儿分为3组，其中脓毒症组20例、严重脓毒症组25例、脓毒性休克组12例；发生肺损伤29例，无肺损伤8例。于发病当日测定血清Angl和Ang2浓度，同时以20例同期儿童保健门诊体检健康儿童20例作为对照组。结果 脓毒症组、严重脓毒症组和脓毒性休克组与健康对照组比较，Ang1水平明显降低（P〈0．01）、Ang2水平明显升高（P〈0．01）；与脓毒性休克组比较，脓毒症组或严重脓毒症组Angl水平明显升高（P〈0．01）、Ang2浓度明显降低（P〈0．05）。并发肺损伤时，脓毒症患儿Ang1水平降低（P〈0．05），Ang2醴水平明显升高（P〈0．01）。结论 Ang1和Ang2是检测脓毒症有意义的生化指标，可以早期预测脓毒症肺损伤的发生。

Change and Significance of Angiopoietin in Children with Sepsis-related Lung Injury

Objective To investigate the changes and significance of serum angiopoietin 1 （ Angl ） and angiopoiefin 2 （Ang 2） in children with sepsis or septic shock. Methods According to the diagnostic criteria and disease severity,57 cases of septic children were divided into greups：20 cases of sepsis group,25 cases of severe sepsis group ,2 cases of septic shock group, and 29 cases of sepsis-related lung injury group. In addition, 20 healthy volunteers were entrolled for control. The serum levels of Angl and Ang2 were measured when sepsis was diagnosed. Results Compared with control group, the level of serum Angl was significantly decreased, and the level of Ang2 was significantly increased in septic shock group, sepsis group and severe sepsis group;compared with septic shock group, the level of Angl was significantly increased, and the level of Ang2 was significantly decreased in sepsis group and severe sepsis group. In addition, the level of serum Angl in sepsis-related lung injury group was reduced and the level of Ang2 was elevated in sepsis-related lung injury group as compared to the group without lung injury. Conclusion Serum Angl and Ang2 are important indexes for detection of sepsis and can be used to predict early sepsis-related lung injury.