兰州大学机构库 >学院待认领
血清瓜氨酸在小儿危重症急性胃肠损伤中的作用探讨
Alternative TitleThe value of citrulline to acute gastrointestinal injury in pediatric critical care unit
朱炜
Thesis Advisor王爱华
2015-05-26
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword瓜氨酸 急性胃肠损伤 危重病
Abstract目的:本研究旨在观察不同程度危重患儿急性胃肠损伤发生情况及血清瓜氨酸浓度变化与急性胃肠损伤之间的关系,探讨血清瓜氨酸在危重患儿病情进展、预后及转归中的作用。方法:收集2013年10月至2014年5月入住兰大二院小儿重症科的患儿96例,排除原发胃肠道疾病、慢性肾功能障碍的患儿。入院24小时内采桡动脉血2ml,其中11例入院3天后再次采血,不抗凝采血管保存,室温静置30min,4 ℃ 下4000r/min离心10min,吸取上层血清-80 ℃保存,后采用高效液相色谱法进行统一检测血清瓜氨酸含量。详细记录纳入患儿的临床资料、检验及影像学结果。结果:非危重组、危重组、极危重组急性胃肠损伤发生率分别为47.06%,75.00%,92.86%(X2=11.848,P=0.003<0.05);非胃肠损伤组平均住院时间为10.59+7.10天,胃肠损伤组平均住院时间为14.88±9.96天,差异有统计学意义(t=2.072 P=0.041<0.05)。胃肠损伤组及非胃肠损伤组血清瓜氨酸浓度为14.655±8.23umol/L,23.522±11.08umol/L(t=4.398,P<0.05);血清瓜氨酸ROC曲线面积为79.8%;治疗3天后血清瓜氨酸浓度较入院时显著升高(t=3.105,P=0.011<0.05);血清瓜氨酸水平越低,病死率越高;血清瓜氨酸水平与CRP、PCT、住院时间呈显著负相关,与血肌酐、尿素氮、白蛋白、胆红素水平无显著相关性。结论:血清瓜氨酸可作为诊断危重症患儿急性胃肠损伤的可靠指标,当发生急性胃肠损伤时血清瓜氨酸显著降低,其诊断的灵敏度及特异度均较高,能准确的反应出胃肠损伤的程度及转归;病情越危重,急性胃肠损伤发生率越高,急性胃肠损伤的发生可导致平均住院时间延长、死亡率升高。
Other AbstractObjective:Our study aims at observing the occurrence of acute gastrointestinal injury under different critical state in pediatric care unit , assessing the connection between citrulline and acute gastrointestinal injury, studying the role of cirtrullin in evaluating the patient's condition , prognosis and changes to critically ill children.Methods:Ninety-six pediatric patients admitted to the second hospital of Lanzhou University were selected from October 2013 to May 2014 ,excluded those with primary gastrointestinal diseases and chronic kidney disease 2ml blood was taken from radial artery within 24 hours of admission,11 patients'blood were taken again after three days.The blood was collected in Anticoagulation tube at room temperature for 30min,and serum was separated by centrifugal machine for 10min at 4℃,And then the serum samples were stored -80℃. We measured the serum concentrations of citrullin by High Performance Liquid Chromatography. Results:The incidence of acute gastrointestinal injuries in non-critical group,critical group, reorganization critical group were 47.06%, 75.00%, 92.86% (X2 = 11.848, P = 0.003 <0.05). The average length of stay in hospital of non- gastrointestinal injury group and gastrointestinal injury group were 10.59+7.10 days,14.88 + 9.96 days, the difference was statistically significant (t = 2.072, P = 0.041 <0.05).The serum citrulline concentrations of gastrointestinal injury group and non- gastrointestinal injury group were 14.655 + 8.231 umol / L, 23.522 + 11.079umol / L (t = 4.398,P <0.05). The area under the ROC curve of citrulline is 79.8%.Serum citrulline concentrations increased significantly after 3 days of treatment compared with admission (t = 3.105, P = 0.011 <0.05) . The lower serum citrulline levels children had, the higher mortality there were.There were negative correlations among serum citrullin and CRP, PCT and length of hospital stay . There were no correlations among serum citrulline and blood urea nitrogen, lactic acid, albumin,and bilirubin levels . Conclusion:Serum citrulline can become a reliable marker to diagnose the acute gastrointestinal injury with high level of sensitivity specificity. It may well reflect the extent of acute gastrointestinal injury and the outcome .The more critically ill children had the higher incidence of acute gastrointestinal injury and acute gastrointestinal injury may lead to the occurrence of prolonged hospitalization and mortality rate.
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222419
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
朱炜. 血清瓜氨酸在小儿危重症急性胃肠损伤中的作用探讨[D]. 兰州. 兰州大学,2015.
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