本文關(guān)鍵詞：PBEF與兒童急性呼吸窘迫綜合征、噬血細(xì)胞綜合征的臨床相關(guān)性　出處：《廣西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 前B細(xì)胞集落刺激因子 急性呼吸窘迫綜合征 兒童 診斷 預(yù)后 前B細(xì)胞集落刺激因子 噬血細(xì)胞綜合征 診斷 鑒別診斷 預(yù)后

【摘要】：目的：探討血漿前B細(xì)胞集落刺激因子（pre-B cell colony-stimulatingfactor, PBEF）水平與兒童急性呼吸窘迫綜合征（acute respiratory distresssyndrome, ARDS）的臨床相關(guān)性。 方法：1、收集入住我院PICU的ARDS患兒及健康兒童的血漿及相關(guān)臨床資料。2、評(píng)定ARDS患兒的PIM2及PRISM評(píng)分。3、使用ELISA法檢測(cè)ARDS患兒及健康兒童血漿PBEF濃度。4、應(yīng)用相應(yīng)統(tǒng)計(jì)學(xué)方法分析比較PBEF水平與相關(guān)臨床指標(biāo)的相關(guān)性。 結(jié)果：1、本研究共收集了59例ARDS患兒及20例健康兒童的血漿及相關(guān)臨床資料。59例ARDS患兒中，幸存患兒46例，死亡患兒13例。2、死亡患兒PIM2評(píng)分及PRISM評(píng)分高于幸存患兒（P＜0.001；P=0.044）。3、ARDS患兒血漿PBEF濃度顯著高于健康兒童［10.74ng/m（lIQR：5.84-18.81ng/ml）VS6.72ng/ml（IQR：5.18-8.73ng/ml）；P=0.017］。ARDS死亡患兒血漿PBEF水平顯著高于幸存患兒［21.55ng/ml（IQR：13.24-23.71ng/ml）VS8.41ng/ml（IQR：5.02-12.23ng/ml）；P=0.002］。4、血漿PBEF水平與WBC（r=0.236，，P=0.036）、Neu（r=0.294，P=0.009）呈正相關(guān)。血漿PBEF水平與PIM2評(píng)分、PRISM評(píng)分之間無(wú)明顯相關(guān)性（P均＞0.05）。 結(jié)論：ARDS患兒血漿PBEF水平顯著升高，死亡患兒血漿PBEF水平明顯高于幸存患兒，提示PBEF可能是診斷兒童ARDS及判斷ARDS患兒預(yù)后的生物標(biāo)志物；但血漿PBEF水平與PIM2評(píng)分、PRISM評(píng)分之間無(wú)明顯相關(guān)性，提示PBEF幫助判斷ARDS患兒預(yù)后的效價(jià)仍有待進(jìn)一步研究。 目的：探討血清前B細(xì)胞集落刺激因子（pre-B cell colony-stimulatingfactor, PBEF）水平與噬血細(xì)胞綜合征（hemophagocytic syndrome, HPS）的臨床相關(guān)性。 方法：1、分別收集我院確診為HPS患兒不同疾病階段的血清標(biāo)本，并收集與患兒年齡、性別、BMI相匹配的健康兒童血清標(biāo)本；收集臨床診斷為膿毒癥，急性淋巴細(xì)胞性白血�。╝cute lymphoblastic leukemia, ALL）患兒的血清標(biāo)本；收集以上所有研究對(duì)象的相關(guān)臨床資料。2、分組：將以上研究對(duì)象分為：HPS治療前組、HPS治療有效組、HPS死亡組、健康兒童組、膿毒癥組及ALL組。3、使用ELISA法檢測(cè)以上血清標(biāo)本的PBEF水平。4、應(yīng)用相應(yīng)統(tǒng)計(jì)學(xué)方法比較各組血清PBEF水平，并分析血清PBEF水平與HPS的臨床相關(guān)性。 結(jié)果：1、HPS治療前組血清PBEF水平明顯高于健康兒童組［33.78ng/ml（IQR：10.28-63.40ng/ml）VS5.37ng/ml（IQR：4.84-6.38ng/ml）；P=0.003］。2、HPS治療前組血清PBEF水平明顯高于膿毒癥組（8.36ng/ml，IQR：4.00-13.01ng/ml）及ALL組（5.75ng/ml，IQR：4.71-7.34ng/ml），差異均有統(tǒng)計(jì)學(xué)意義（P=0.01，P=0.004）；膿毒癥組、ALL組與健康兒童組血清PBEF水平差異無(wú)統(tǒng)計(jì)學(xué)意義（P＞0.05）。3、HPS治療前組血清PBEF水平（33.78ng/ml，IQR：10.28-63.40ng/ml）明顯高于HPS治療有效組（5.87ng/ml，IQR：4.14-7.75ng/ml）（P=0.001）；HPS治療前組與HPS死亡組（95.24ng/ml, IQR:16.76-211.82ng/ml）血清PBEF水平差異無(wú)統(tǒng)計(jì)學(xué)意義（P=0.328）；HPS治療有效組（5.87ng/ml, IQR:4.14-7.75ng/ml）與健康兒童組（5.37ng/ml，IQR:4.84-6.38ng/ml）血清PBEF水平差異無(wú)統(tǒng)計(jì)學(xué)意義（P=0.550）；HPS死亡組血清PBEF水平明顯高于HPS治療有效組及健康兒童組（P=0.004，P=0.001）。4、PBEF與體溫（r=0.343，P=0.004）、SF（r=0.651，P=0.001）呈正相關(guān)。 結(jié)論：1、與健康兒童、膿毒癥及ALL患兒相比，HPS患兒治療前血清PBEF水平均明顯升高，提示檢測(cè)PBEF水平可能有助于HPS的診斷和鑒別診斷。2、HPS患兒有效治療后血清PBEF水平降至正常，而死亡患兒PBEF水平依然處于較高水平，提示PBEF與HPS疾病活性相關(guān)，有可能成為HPS的預(yù)后指標(biāo)；HPS患兒治療過程中，若其血清PBEF水平無(wú)明顯降低時(shí)，應(yīng)警惕患兒病情是否未得到控制或惡化。
[Abstract]:Objective: To investigate the clinical correlation between plasma B pre-B cell Colony-StimulatingFactor (PBEF) level and acute respiratory distresssyndrome (ARDS) in children.
Methods: 1 patients with ARDS and healthy children were collected in our hospital PICU plasma and clinical data of.2, PIM2 and PRISM ARDS were assessed using.3 score, ELISA was detected with ARDS and healthy children in the plasma concentration of PBEF and.4, application of appropriate statistical methods to analyze the correlation between PBEF level and related clinical indicators.
Results: 1, this study collected a total of 59 cases of ARDS and 20 cases of healthy children in plasma and clinical data of.59 patients with ARDS, 46 patients survived, 13 cases were dead.2, death with PIM2 score and PRISM score was higher than that of surviving patients (P < 0.001;.3, P=0.044) ARDS children plasma the concentration of PBEF was significantly higher than that of healthy children 10.74ng/m (lIQR:5.84-18.81ng/ml) VS6.72ng/ml (IQR:5.18-8.73ng/ml); plasma PBEF level in P=0.017 patients was significantly higher than that of the children who survived.ARDS death 21.55ng/ml (IQR:13.24-23.71ng/ml) VS8.41ng/ml (IQR:5.02-12.23ng /ml); P=0.002.4, plasma PBEF level and WBC (r=0.236, P=0.036), Neu (r=0.294, P=0.009) were positively related to plasma. The level of PBEF and PIM2 scores, no significant correlation between PRISM scores (P < 0.05).
Conclusion: the level of PBEF in plasma of patients with ARDS significantly increased the plasma level of PBEF was significantly higher than that with the death of the children who survived, suggesting that PBEF may be a diagnosis of children ARDS and ARDS children to determine prognosis biomarkers; but the level of plasma PBEF and PIM2 score, PRISM score had no significant correlation between, suggesting that PBEF help to judge the prognosis of ARDS remains to be. Further study.
Objective: To investigate the clinical correlation between serum B pre-B cell Colony-StimulatingFactor (PBEF) level and hemophagocytic syndrome (HPS).
Methods: 1 patients in our hospital were collected for serum samples of HPS patients in different stages of disease, gender and age of the patients were collected, and BMI matched healthy children serum samples collected; clinical diagnosis of sepsis, acute lymphoblastic leukemia (acute lymphoblastic, leukemia, ALL) of serum samples were collected from all of the above studies; the clinical data of.2, grouping: the above research object is divided into: before HPS treatment group, HPS treatment group, HPS death group, healthy children group, sepsis group and ALL group.3, using ELISA method to detect serum PBEF levels above.4, serum PBEF levels were compared using the corresponding statistical method clinical relevance, and analysis of the serum level of PBEF and HPS.
Results: 1, HPS group before the treatment, the serum level of PBEF was significantly higher than that of healthy children in group 33.78ng/ml (IQR:10.28-63.40ng/ml) VS5.37ng/ml (IQR:4.84-6.38ng/ml); P=0.003.2, HPS group before the treatment, the serum level of PBEF was significantly higher than that in sepsis group (8.36ng/ml, IQR:4.00-13.01ng/ml) and ALL group (5.75ng/ml, IQR:4.71-7.34ng/ml), the differences were statistically significant (P=0.01. P=0.004); sepsis group, there was no significant difference between ALL group and the group of healthy children serum PBEF levels (P > 0.05).3, HPS group before the treatment, the serum level of PBEF (33.78ng/ml, IQR:, 10.28-63.40ng/ml) was significantly higher than that of HPS treatment group (5.87ng/ml, IQR:4.14-7.75ng/ml) (P=0.001); HPS group and HPS group before the treatment of death (95.24ng/ml, IQR:16.76-211.82ng/ml) had no significant difference between the serum level of PBEF (P=0.328); HPS treatment group (5.87ng /ml, IQR:4.14-7.75ng/ml (5.3) and the group of healthy children There was no significant difference in serum PBEF level between 7ng/ml and IQR:4.84-6.38ng/ml (P=0.550); the serum PBEF level in HPS death group was significantly higher than that in HPS treatment group and healthy children group (P=0.004, P=0.001).4, and there was a positive correlation between PBEF and body temperature (P=0.001).
Conclusion: 1, compared with healthy children, sepsis and ALL patients, HPS patients before treatment serum PBEF levels were significantly increased, suggesting that.2 diagnosis and differential diagnosis to detect the level of PBEF may contribute to HPS, effective treatment of HPS patients after serum PBEF level decreased to normal, and death PBEF levels were still at high level. The results indicated that the activity of PBEF and HPS related diseases, may become a prognostic marker in HPS patients treated with HPS; in the process, if the serum level of PBEF had no significant decrease, should be alert to whether children with the disease has not been controlled or worse.

【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R725.6

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相關(guān)期刊論文 前2條

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本文編號(hào)：1379961