轮状病毒感染性脓毒症患儿血清降钙素原、白细胞介素-6、肿瘤坏死因子-α水平变化的意义

目的探讨急性轮状病毒感染性脓毒症患儿血清中降钙素原(PCT)、IL-6、TNF-α水平变化的意义。方法根据小儿脓毒症诊断标准,将本院儿科86例轮状病毒肠炎患儿分为非脓毒症组46例和脓毒症组40例,同期选取35例健康儿童作为健康对照组。采用双抗体夹心ELISA法测定其血清PCT、IL-6、TNF-α水平,比较脓毒症组、非脓毒症组及健康对照组血清PCT、IL-6、TNF-α水平的差异。轮状病毒肠炎肠外脏器损害的41例中根据是否伴有脓毒症分为非重症感染组(肠外脏器损害+非脓毒症)18例和重症感染组(肠外脏器损害+脓毒症)23例,比较2组血清PCT、IL-6、TNF-α水平的差异。结果 1.非脓毒症组血清PCT、IL-6、TNF-α水平明显高于健康对照组(Pa<0.05),脓毒症组血清PCT、IL-6、TNF-α水平明显高于健康对照组(Pa<0.01),脓毒症组血清IL-6、TNF-α水平明显高于非脓毒症组(Pa<0.01),但血清PCT水平脓毒症组与非脓毒症组比较差异无统计学意义(P>0.05)。2.重症感染组血清PCT、IL-6水平高于非重症感染组,差异均有统计学意义(Pa<0.01);重症感染组血清TNF-α水平高于非重症感染组,差异有统计学意义(P<0.05)。结论小儿轮状病毒感染后血清PCT、IL-6、TNF-α水平升高,临床表现为脓毒症时血清PCT、IL-6、TNF-α升高更明显,尤其是PCT升高时提示轮状病毒感染可能引起肠外多个脏器功能损害。

Changes of Procalcitonin, Interleukin-6,Tumor Necrosis Factor Alpha Levels in Children with Sepsis for Rotavirus Infection and Their Significances

Objective To explore the changes of procalcitonin(PCT),interleukin-6(IL-6) and tumor necrosis factor alpha(TNF-α) serum concentration and their significance in children with sepsis by acute rotavirus infection.Methods Eighty-six children with acute rotavirus enteritis and a healthy control group with 35 healthy children were included in the study.According to the diagnostic criteria in children with sepsis,86 cases were divided into 2 groups(46 cases without sepsis as group without sepsis,40 cases with sepsis as sepsis group).The PCT,IL-6 and TNF-α serum concentrations were compared among 3 groups.The PCT,IL-6 and TNF-α serum concentrations were tested by double resistance to sandwich enzyme linked immunosorbent assay.Forty-one cases with extra-intestinal organs impairment were divided into mild to moderate infective group(18 cases) and severe infective group(23 cases of sepsis);the PCT,IL-6 and TNF-α se-rum concentrations were compared between the 2 groups.Results In the group without sepsis,all of the IL-6,PCT,TNF-α serum were obviously higher than those in the healthy control group(Pa<0.05).Compared with the healthy control group,the PCT,IL-6,TNF-α serum concentrations in sepsis group were obviously higher than the former(Pa<0.01).Compared with the group without sepsis,the IL-6,TNF-α serum concentrations in the sepsis group were significantly different(Pa<0.01),but there was no significant difference in PCT serum concentrations(P>0.05).In 41 cases with extra-intestinal organ damage,the PCT,IL-6 and TNF-α serum concentrations were significantly different in 2 groups(Pa<0.01,0.05).The serum concentrations were higher in the group with severe infection.Conclusions In the pediatric rotavirus infection,the PCT,IL-6,TNF-α serum concentration levels are elevated more or less.Their concentration levels were higher in the cases with sepsis significantly.The PCT concentration elevation may suggests that the clinicians should be watchful to multiple organ impairment out of the intestinal tract by pediatric rotavirus infection.