铁蛋白、红细胞参数及血浆D-二聚体与儿童脓毒症的相关性

目的探讨红细胞参数、血浆D-二聚体(D-dimer,DD)、铁蛋白(serum ferritin,SF)对儿童脓毒症病情及预后的评估价值。方法回顾性分析2015年7月至2022年6月江苏省无锡市儿童医院173例脓毒症患儿的血红蛋白(hemoglobin,Hb)、红细胞体积分布宽度(red blood cell distribution width,RDW)、DD、SF、危重程度及预后,并探讨相互关系和相关机制。结果脓毒症患儿非危重组82例,危重组64例,极危重组27例;随危重程度增加,Hb逐渐降低,RDW、DD、SF逐渐增高,差异均有统计学意义(P<0.01);Hb与RDW、DD、SF均呈负相关(r=-0.527、-0.629、-7.324,P<0.05),RDW与DD正相关(r=0.587,P<0.05),SF与RDW、DD均正相关(r=0.513、0.697,P<0.05)。脓毒症患儿死亡21例,存活152例;死亡组Hb较存活组低,RDW、DD、SF较存活组高,差异均有统计学意义(P<0.01)。脓毒症组124例,脓毒性休克组49例;脓毒症组Hb较脓毒性休克组高,RDW、DD、SF较脓毒性休克组低,差异均有统计学意义(P<0.01)。结论Hb、RDW、DD、SF对儿童脓毒症的病情及预后评估有一定价值,微循环障碍损伤的红细胞是儿童脓毒症SF的主要来源。

Correlation of serum ferritin,erythrocyte parameters and D-dimer with sepsis in children

Objective To investigate the evaluation value of erythrocyte parameters, D-dimer (DD) and serum ferritin (SF) on the state and prognosis of sepsis in children, and to explore their relationship. Methods We carried out a retrospective analysis on 173 children with sepsis who visited Wuxi Children's Hospital of Jiangsu Province from July 2015 to June 2022, including Hemoglobin(Hb), red blood cell distribution width(RDW), DD, SF, the severity of illness and the prognosis, and explored its interrelation and related mechanism. Results There were 82 cases in non-severe group, 64 cases in severe group and 27 cases in extremely severe group. Hb was decreased and RDW, DD and SF were increased gradually with increased severity of illness, with statistically significant differences (P<0.01). Hb was negatively correlated with RDW and DD (r=-0.527 and -0.629, P<0.05). RDW was positively correlated with DD(r=0.587, P<0.05). SF was negatively correlated with Hb(r=-7.324, P<0.05). SF was positively correlated with RDW and DD (r=0.513 and 0.697, P<0.05). Among 173 children with sepsis, there were 21cases in death group and 152 cases in survival group. Hb in death group was significantly lower than that in survival group and RDW, DD and SF in death group were significantly higher than those in survival group (P<0.01). There were 124 children in sepsis group and 49 children in septic shock group. Hb in sepsis group was significantly higher than that in septic shock group, and RDW, and DD and SF were significantly lower than those in septic shock group (P<0.01). Conclusion Hb, RDW, DD and SF have some evaluation value on the state and prognosis of sepsis in children, and the erythrocytes damaged by microcirculation disturbance may be the main source of SF.