脓毒症患儿低蛋白血症与CRP及PCT的相关性

Correlation of hypoproteinemia with C-reactive protein and procalcitonin in children with sepsis

摘要:

目的：探讨脓毒症患儿低蛋白血症与炎症指标的相关性。方法：收集确诊为脓毒症患儿73例，其中严重脓毒症22例，并收集非脓毒症患儿40例作为对照组，测定血清白蛋白水平，并根据白蛋白水平将73例脓毒症患儿分为3个亚组：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个亚组CRP、PCT、WBC的变化，并对3个炎症指标与白蛋白水平进行相关性分析。结果：严重脓毒症组和非严重脓毒症组白蛋白水平明显低于对照组（P<0.05）。其中严重脓毒症组白蛋白水平较非严重脓毒症组降低，差异有统计学意义（P<0.05）。73例脓毒症患儿中，轻、重度低蛋白血症组 CRP、PCT及WBC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），且血清白蛋白水平与CRP、PCT、WBC呈负相关。结论：脓毒症患儿白蛋白水平明显降低，且随病情的加重而进一步降低，白蛋白水平越低，预后越差。反应脓毒症的炎症指标CRP、PCT、WBC与血清白蛋白水平呈负相关。［中国当代儿科杂志，2010，12（11）：870-873］

Abstract:

OBJECTIVE: To investigate the correlation of hypoproteinemia with inflammation parameters C-reactive protein (CRP), procalcitonin (PCT) and WBC in children with sepsis. METHODS: Seventy-three children with sepsis (including 22 severe sepsis) and 40 non-sepsis children (control group) were enrolled. Serum albumin levels were measured on admission. Based on the level of serum albumin, 73 cases of sepsis were classified into three groups: mild hypoproteinemia, severe hypoproteinemia and normal albumin. Blood CRP, PCT and WBC levels were compared in the three groups. The correlation of CRP, PCT and WBC with serum albumin level was evaluated. RESULTS: Serum albumin levels in the sepsis groups (severe or non-severe) were significantly lower than those in the control group (P<0.05), and the severe sepsis group showed more decreased albumin levels compared with the non-severe sepsis group (P<0.05). Blood CRP, PCT and WBC levels in the mild hypoproteinemia group were higher than those in the normal albumin group (P<0.05), and the severe hypoproteinemia group showed more increased blood CRP, PCT and WBC levels compared with the mild hypoproteinemia group (P<0.05). The incidence of multiple organ failure in the severe hypoproteinemia group was significantly higher than that in the normal albumin group (P<0.05). Serum albumin levels were negatively correlated with blood CRP, PCT and WBC levels. CONCLUSIONS: Serum albumin levels decrease in children with sepsis, and the more serious the illness, the lower serum albumin levels, resulting in a worse prognosis. CRP, PCT and WBC are negatively correlated to serum albumin levels in children with sepsis.［Chin J Contemp Pediatr, 2010, 12 (11):870-873］