新生儿败血症血清中降钙素原含量对炎症反应程度、脏器功能损伤的评估价值

摘要

目的:探讨新生儿败血症血清中降钙素原含量对炎症反应程度、脏器功能损伤的评估价值.方法:选取在本院进行治疗的新生儿败血症患儿48例作为观察组,另取同期在本院分娩的健康新生儿50例作为正常对照组,根据观察组血清PCT含量中位数进一步分为高PCT组、低PCT组各24例.采用酶联免疫吸附法(ELISA)测定各组新生儿血清炎症介质含量,彩色多普勒超声诊断仪测定心脏功能损伤指标水平.结果:观察组外周血PCT含量显著高于对照组(P<0.05);高PCT组、低PCT组血清中炎症介质IL-1β、IL-6、IL-8、TNF-α含量显著高于正常对照组,PCT含量上升,血清炎症介质IL-1β、IL-6、IL-8、TNF-α含量增加(P<0.05);高PCT组、低PCT组常规超声参数CO、LVEF水平,二维斑点追踪成像参数GLSr、GCSr绝对值低于正常对照组,血清中心肌损伤指标cTnⅠ、H-FABP、HBDH的含量高于正常对照组,PCT含量上升,CO、LVEF水平及GLSr、GCSr绝对值降低,指标cTnⅠ、H-FABP、HBDH的含量增加(P<0.05).结论:新生儿败血症血清中PCT含量与炎症反应程度、心功能损伤程度呈正相关,可作为早期判断病情严重程度及靶器官损伤的可靠指标.%Objective: To study the value of serum procalcitonin content for assessing the inflammation and organ injury in neonatal sepsis.Methods: A total of 48 children with neonatal sepsis who were treated in our hospital between April 2014 and May 2016 were selected as the observation group, 50 healthy newborns who were delivered in our hospital during the same period were selected as the normal control group, and the observation group were further divided into high PCT group and low PCT group (n=24) according to the median of serum PCT content.Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum contents of inflammatory mediators, and color Doppler diasonograph was used to measure heart injury index levels.Results: Peripheral blood PCT content of observation group was significantly higher than that of control group (P<0.05);serum inflammatory mediators IL-1β, IL-6, IL-8 and TNF-α contents of high PCT group and low PCT group were significantly higher than those of normal control group, and as the PCT content increased, serum inflammatory mediators IL-1β, IL-6, IL-8 and TNF-α contents increased (P<0.05);routine ultrasound parameters CO and LVEF levels as well as the absolute value of two-dimensional speckle tracking imaging parameters GLSr and GCSr of high PCT group and low PCT group were lower than those of normal control group while serum myocardial injury indexes cTnⅠ, H-FABP and HBDH contents were higher than those of normal control group, and as the PCT content increased, CO and LVEF levels as well as the absolute value of GLSr and GCSr decreased while the indexes cTn, H-FABP and HBDH contents increased (P<0.05).Conclusions: Serum PCT content is positively correlated with the degree of inflammation and heart injury in neonatal sepsis, and can be used as a reliability index to early judge the disease severity and the target organ damage.