目的：探讨血清前白蛋白(PA) 与视黄醇结合蛋白(RBP) 在儿童脓毒血症肝、肾功能早期损伤中的临
床意义。方法：收集湖南省人民医院儿童医学中心呼吸病房201 年2~10 月住院的脓毒血症患儿100 例，完全符
合入组标准者 0 例。非脓毒血症患儿100 例，符合入组标准者 例，取同期正常体检儿童 0 例为正常对照组，
分别收集三组相关临床资料，采用日立 00 全自动生化分析仪检测肝肾功能及PA 与RBP 水平，并进行统计学
分析。结果：脓毒血症组PA、RBP 含量均明显低于非脓毒血症组和正常对照组，差异有统计学意义；非脓毒血症
组PA 及RBP 水平较正常组均稍低，但差异无明显统计学意义。与非脓毒血症组与正常对照组相比，脓毒血症组
WBC 计数、中性粒细胞百分比、CRP、血糖、谷丙转氨酶增高、血清白蛋白(ALB) 降低，差异均有统计学意义，肌酐、
尿素氮、总胆红素、直接胆红素等均无明显统计学差异。结论：PA 及RBP 水平的变化是早期肝、肾功能损害的因
子，血清PA 与RBP 下降有利于发现脓毒血症患儿早期脏器损伤。
Abstract
Objective To discuss whether prealbumin (PA)and retinol-binding protein(RBP) in early stage of liver and renal
injury were significative to sepsis in children. Methods 100 sepsis patients were enrolled from the respiratory ward of Children’
s Medical Center in Hunan Provincial People’s Hospital from February 2014 to October 2014,and among them above 90 cases
were full compliance with the standard.98 cases were full compliance with the standard in 100 cases with non-sepsis. Took 80
healthy children in the same period by physical examination as normal control group. Measured the concentrations of the liver
function, renal function, PA and RBP using Hitachi 7600 automatic biochemical analyzer .Collected relevant clinical data of the
three groups for statistical analysis at the same time. Results The levels of PA and RBP in Sepsis group were significantly lower
than non-sepsis group and the normal group.The levels of PA and RBP in the Non-sepsis group were slightly lower than the normal
group, but the difference was not statistically significant.In sepsis group ,the levels of WBC count, N%, CRP, BS, ALT were
higher than non-sepsis group and the normal group, and ALB in sepsis group were lower than other two groups，and the differences
of them were all statistically significant.There were no significant statistical differences, in other indicators including Cr,
BUN, TBIL , dBIL. Conclusion The changes of the levels of PA and RBP may participate in the early damage of liver and renal
fμnction.The decrease in the levels of PA and RBP could be used for finding the early damage of organ in Children’s sepsis.
关键词
血清前白蛋白 /
视黄醇结合蛋白 /
脓毒血症 /
早期肝功能损害
Key words
prealbumin /
retinol-binding protein;sepsis;the early damage of liver function
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
参考文献
［1］ O'Brien JM Jr, Ali NA, Aberegg SK,et al.Sepsis［J］. Am J Med, 200 ,
120(12): 1012-1022.
［2］ Hrnciarikova D, Juraskova B, Hyspler R, et al. A changed view of serum
prealbumin in the elderly: prealbumin values influenced by concomitant
inflammation［J］. Biomed Pap Med Fac Univ Palacky Olomouc Czech
Repub, 200 , 151(2): 2 -2 .
［ ］ Norden AG,Lapsley M,Unwin RJ.Urine retinol-binding protein :
a functional biomarker of the proximal renal tubule［J］.Adv Clin
Chem,201 , : 5-122.
［ ］ 童桂兰,杨沛华,刘春文,等.血清前白蛋白的临床应用价值［J］.中国
中西医结合消化杂志,2012,20(5):2 2-2 .
［5］ Dellinger RP,Levy MM,Rhodes A.Surviving sepsis campaign:intemational
guidelines for management of severe sepsis and septic shock
2012［J］.Intensive Care Medicine, 201 ,2:1 5-22 .
［ ］ Goldstein B,Giroir B,Randolph A.International pediatric sepsis
consensμs conference： definitions for sepsis and organ dysfunction in
pediatrics［J］.Pediatr Crit Care Med,2005, (1):2- .
［ ］ 孟启勇,向镜芬.免疫功能改变对脓毒症患者预后的影响［J］.湖南
师范大学学报(医学版),201 ,10(2): 1- .
［ ］ Vesteinsdottir E，Karason S，Sigurdsson SE,et al.Severe sepsis and septic
shock: a prospective population based study in Icelandic intensive
care units［J］. Acta Anaesthesiol Scand,2011,55: 22- 1.
［ ］ Sudhir U,Venkatachalaiah RK, Kumar TA,et al.Singnificance of serum
procalcitonin in sepsis［J］.Indian J Crit Care Med,2011,15(1):1-5.
［10］ Tajiri K,Shimizu Y.Practical guidelines for diagnosis and early management
of drug-induced liver injury［J］.World J Gastroenterol, 200 , 1 :
- 5.
［11］ Shenkin A.Serum prealbumin:Is it a marker of nutritional status or of
risk of malnutrition［J］.Clin Chem,200 ,52(12):21 -21 .
［12］ Hou M,Sun S,Jiang ZA new and selective and sensitive nanogoldlabeled
immunoresoance scattering spectral assay for trace prealbumin
［J］.Talanta,200 , 2: - .
［1 ］ Lourenco P,Silva S,Frioes F,et al.Low prealbumin is strongly associated
with adverse outcome in heart failure［J］. Heart,201 ,100(22):1 0-1 5.
［1 ］ Klenzak J,Himmelfarb J.Sepsis and the kidney［J］. Crit Care Clin, 2005,
21(2): 211-222.
PDF(1510 KB)
