摘要
目的:研究应激性高血糖对脓毒血症儿童免疫功能和预后的影响。方法:从2013年5月至2014年5月,对纳入本次研究的39例脓毒血症患儿根据血糖情况分为应激性高血糖组(18例,即观察组)和正常血糖组(21例,即对照组)。经流式细胞仪检测,比较两组患儿在1 d内的Th1/Th2值、CD4+/CD8+值,CD14+单核细胞白细胞抗原-DR(HLA-DR)的表达情况;观察两组患儿慢性健康状况、急性生理学评分系统Ⅱ(APACHEⅡ)和感染的衰竭器官评分(SOFA),并对1个月的临床结局予以随访。结果:观察组患儿的SOFA评分为(5.64±1.34)分,APACHEⅡ评分为(18.94±4.23)分,确诊时血糖为(11.98±2.53)mmol·L-1,均高于对照组,差异均具有统计学意义(P<0.05)。观察组患儿的HLA-DR活化水平为(71.23±13.24)%,CD4+/CD8+为1.13±0.14,均低于对照组,差异均具有统计学意义(P<0.05)。观察组患儿的死亡率为55.56%(10/18),高于对照组的14.29%(3/21),差异有统计学意义(P<0.05)。结论:应激性高血糖可对脓毒血症儿童细胞免疫功能产生影响。
Objective： To study the influence of stress hyperglycemia on immune function and prognosis in children with sepsis. Methods： Thirty-nine children with sepsis admitted to our hospital from May 2013 to May2014 were divided into observation group of stress hyperglycemia（ 18 cases） and control group of normal blood sugar（ 21 cases） according to their blood sugar levels. Th1 /Th2 ratio,CD4＋/ CD8＋ratio,CD14＋monocyte HLA-DR（ HLA-DR） expression within a day were compared and determined by flow cytometry. Chronic health evaluation Acute Physiology Score System Ⅱ（ APACHE Ⅱ） score and organ failure assessment and infection score（ SOFA）were calculated in the two groups. And the clinical outcomes were followed up for a month. Results： SOFA score（ 5. 64 ± 1. 34）,APACHE Ⅱ score（ 18. 94 ± 4. 23） and the blood glucose level（ 11. 98 ± 2. 53） mmol·L^-1 of the observation group were higher than those of the control group,the difference being statistically significant（ P〈0. 05）. Levels of monocyte activation（ HLA-DR expression）（ 71. 23 ± 13. 24） % and CD4^＋/ CD8^＋ratio（ 1. 13 ±0. 14） of the observation group were lower than those of the control group,showing significant differences（ P〈0. 05）. The mortality rate of the observation group was higher（ 55. 56%,10 /18） than that（ 14. 29%,3 /21） of the control group with significant differences（ P〈0. 05）. Conclusion： The stress hyperglycemia in children with sepsis influences the immune function.
出处
《现代医学》
2016年第3期288-291,共4页
Modern Medical Journal
