脓毒症患儿心功能与血清TNF-α、IL-1β水平的相关性分析

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Abstract Objective To explore the correlation between heart function and serum tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels in children with sepsis. Methods From October 2016 to October 2019, a total of 126 children with sepsis admitted to the Second Department of Emergency of Hu′nan Children′s Hospital (hereinafter referred to as “our hospital”) were divided into non-myocardial injury group (group A, 49 cases) and myocardial injury group (group B, 77 cases). According to the left ventricular ejection fraction (LVEF), the group B was divided into mild (group B1, 23 cases), medium (group B2, 34 cases), and severe (group B3, 20 cases) myocardial injury group. In the same period, a total of 50 children in our hospital were selected as the control group. The differences in the cardiac function indexes and serum TNF-α and IL-1β levels of each group were compared. Results Acute physiology and chronic health scoring system Ⅱ (APACHE Ⅱ) score, serum cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), N-terminal B-type natriuretic peptide pre Body (NT-proBNP), TNF-α, IL-1β were higher than those in the control group, while LVEF, early mitral valve filling peak velocity E peak / atrial systolic maximum flow velocity A peak (E/A) were lower than those in the control group, and the differences were statistically significant (P < 0.05); moreover, the differences between the above-mentioned index groups between group A and group B were statistically significant (P < 0.05). Comparison of APACHE Ⅱ, LVEF, E/A and cTnI, CK-MB, NT-proBNP, TNF-α, IL-1β in children with different levels of myocardial injury, and the differences were highly statistically significant (P < 0.01); APACHEⅡ, cTnI, CK-MB, NT-proBNP, TNF-α and IL-1β in group B2 and group B3 were all higher than those in group B1, and the differences were statistically significant (P < 0.05); in addition, the differences between the index in B2 group and B3 group were statistically significant (P < 0.05). Serum TNF-α and IL-1β in children with septic myocardial injury were negatively correlated with LVEF and E/A (P < 0.01), while there were positively correlated with serum cTnI, CK-MB, and NT-proBNP (P < 0.01). When the best cut-off values of TNF-α and IL-1β were 80.26 pg/mL and 8.83 pg/mL, respectively, the sensitivity and specificity were 87.6% and 93.5%, 90.5% and 93.5%, respectively; when the four were combined, the sensitivity and specificity were 97.6% and 94.1%. Conclusion Serum TNF-α and IL-1β levels can reflect myocardial damage in children with sepsis, and can be used as reliable markers for the early diagnosis of myocardial damage in children with sepsis. Combined detection with cardiac function indicators can improve accuracy.

Key words： Children Sepsis Myocardial injury Inflammatory factors

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	LUO Lan ZENG Fanglin LONG Caixia CHEN Yanying ZHOU Haiyin

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LUO Lan ZENG Fanglin LONG Caixia CHEN Yanying ZHOU Haiyin. Correlation analysis of heart function and serum TNF-α, IL-1β levels in children with sepsis[J]. 中国医药导报, 2020, 17(30): 16-19,23.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I30/16

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