| 单核细胞趋化蛋白-1在脓毒症患儿血浆中的表达及其对心肌损伤影响的初步研究 |
| Alternative Title | Expression of plasma monocyte chemotactic protein-1 in children with sepsis and study of the effect of myocardial injury
|
| 于培儒 |
| Thesis Advisor | 董湘玉
|
| 2011-05-24
|
| Degree Grantor | 兰州大学
|
| Place of Conferral | 兰州
|
| Degree Name | 硕士
|
| Keyword | 单核细胞趋化蛋白-1
心肌损伤标志物
脓毒症
|
| Abstract | 目的：探讨人单核细胞趋化蛋白-1（MCP-1）在儿童脓毒症不同时期血浆中的表达及其与心肌损伤严重程度的相关性。
方法：将2009-7至2010-7入住兰州大学第二医院儿科ICU的62例危重症患儿，按国际脓毒症标准分为4组：感染组（25例）、脓毒症组（17例）、严重脓毒症组（12例）、脓毒症休克组（8例）4组，50例儿童保健门诊的健康儿童作为对照组，采用新型夹心免疫荧光法检测各组患儿血浆中MCP-1的浓度和超敏C-反应蛋白、CK-MB、cTnI等比较。
结果：感染组、脓毒症组、严重脓毒症组、脓毒症休克组患儿入院当天血浆MCP-1平均浓度（52.89 ng/L 、146.40 ng/L 、321.06 ng/L 、480.43ng/L）逐渐升高，差异有统计学意义（P<0.05）。与超敏C-反应蛋白、CK-MB相比，死亡患儿血浆的MCP-1浓度比存活患儿明显升高，差异有统计学意义（P<0.05）。在住院第一天差异即非常明显。所有患儿接受者操作特性曲线（R0C）中MCP-1和cTnI的曲线下面积相近，明显高于超敏C-反应蛋白、CK-MB组 。
结论：血浆中MCP-1浓度测定对脓毒症患儿严重程度分层评估和心肌损伤早期特异性诊断有极大地临床价值。 |
| Other Abstract | Objective:To evaluate the expression of plasma monocyte chemotactic protein-1 in children with sepsis and relationship of myocardial injury’s severity.
Methods: According to the international sepsis criteria 62 critically ill patients admitted to the department of paediatrics were classified into four groups: Infection ( 25) sepsis ( 17) , severe sepsis (12 ) and septic shock ( 8 ) , with 50 healthy individuals as control groups. The level of plasma monocyte chemotactic protein-1 was measured in each group, and compared with the other biomarkers of myocardial injury (hs-CRP、CK-MB、cTnI), monocyte chemotactic protein-1 was detected using a new sandwich immunoassay.
Results :Monocyte chemotactic protein-1 concentration was 52.89ng/L for Infection, 146.40 ng/L for sepsis, 321.06 ng/L for severe sepsis and 480.43 ng/L for septic shock, the plasma concentration of monocyte chemotactic protein-1 exhibited a gradual increase, and the monocyte chemotactic protein-1 value was greatest in the septic shock group. Comparing with the other biomarkers of myocardial injury, in the sepsis, severe sepsis and septic shock group, the plasma concentration of monocyte chemotactic protein-1 in the nonsurvivors was significantly greater than in the survivors ( P < 0.05) , and the difference in monocyte chemotactic protein-1 values was clear on the first day of admission to the department of paediatrics ( P < 0.05). By the receiver operating characteristic (ROC) plot analysis of monocyte chemotactic protein-1 in sepsis patients, the area under the ROC curve for monocyte chemotactic protein-1 was similar to the area under the ROC curve for cTnI and was significantly higher than the area under the ROC curve for hs-CRP and CK-MB.
Conclusion: The measurement of monocyte chemotactic protein-1 has great clinical value in the early specifical diagnosis of myocardial injury and risk assessment in sepsis. |
| URL | 查看原文
|
| Language | 中文
|
| Document Type | 学位论文
|
| Identifier | https://ir.lzu.edu.cn/handle/262010/223666
|
| Collection | 学院待认领
|
| Affiliation | 临床医学院
|
Recommended Citation
GB/T 7714 |
于培儒. 单核细胞趋化蛋白-1在脓毒症患儿血浆中的表达及其对心肌损伤影响的初步研究[D]. 兰州. 兰州大学,2011.
|
Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.
