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目的比较全身炎症反应综合征(SIRS)患儿与健康儿童血清IL-6、inter-α抑制蛋白(IαIP)水平,并动态观察IαIP/IL-6比值在SIRS发展过程中的变化。方法根据SIRS的诊断标准,将本院儿科收治的38例SIRS患儿纳入SIRS组,同期选取22例健康儿童作为健康对照组,采用Western blot法检测其血清IαIP水平,并对其条带进行灰度扫描,采用ELISA法测定其血清IL-6水平,比较SIRS组与健康对照组血清IL-6、IαIP水平。参照小儿各系统功能障碍诊断标准,将住院过程中新出现1个以上器官功能障碍者作为恶化组,并将SIRS组治疗痊愈或好转的患儿作为治愈/好转组,病情恶化或死亡的患儿作为恶化/死亡组,比较2组血清IL-6、IαIP水平及IαIP/IL-6比值;在恶化/死亡组中比较恶化后与入院时血清IL-6、IαIP水平和IαIP/IL-6比值。结果 1.SIRS组血清IL-6水平明显高于健康对照组(P<0.01),而SIRS组血清IαIP水平明显低于健康对照组(P<0.01)。2.病情恶化/死亡组与治愈/好转组相比,血清IL-6水平显著升高(P<0.01),而血清IαIP水平、IαIP/IL-6比值均显著降低(Pa<0.01)。3.病情恶化组患儿病情恶化后与入院时比较,血清IL-6水平显著升高(P<0.01),而血清IαIP水平、IαIP/IL-6比值均显著降低(Pa<0.01)。结论血清IL-6、IαIP水平与IαIP/IL-6比值的高低可判断SIRS的预后。
Objective To compare the levels of serum IL-6 and inter-alpha inhibitory protein (IαIP) in children with systemic inflammatory response syndrome (SIRS) and healthy children and to observe the change of IαIP / IL-6 ratio in the development of SIRS. Methods According to the diagnostic criteria of SIRS, 38 children with SIRS admitted to our hospital were enrolled in the SIRS group. Twenty-two healthy children were selected as the healthy control group at the same period. The serum IαIP level was detected by Western blotting and the bands were gray The serum levels of IL-6 were measured by ELISA. The serum levels of IL-6 and IαIP in SIRS group and healthy control group were compared. According to the diagnostic criteria of pediatric dysfunction, we identified one or more newly diagnosed organ dysfunction during the hospitalization as the worsening group, and treated the children in the SIRS group as cured or remission group, who were exacerbated or died Serum levels of IL-6, IαIP and IαIP / IL-6 were compared between the two groups as deteriorating / death group; serum IL-6, IαIP levels and IαIP / IL-6 ratio . Serum IL-6 level in SIRS group was significantly higher than that in healthy control group (P <0.01), while serum IαIP level in SIRS group was significantly lower than that in healthy control group (P <0.01). Serum levels of IL-6 were significantly increased (P <0.01), while levels of serum IαIP and IαIP / IL-6 were significantly decreased (P <0.01). Serum levels of IL-6 were significantly increased (P <0.01), while the levels of serum IαIP, IαIP / IL-6 were significantly decreased (P <0.01). Conclusion The prognosis of SIRS can be judged by the level of serum IL-6, IαIP and IαIP / IL-6.