The Level And Clinical Significance Of Serum Cytokines In Children With Sepsis

Objectives:Sepsis is systemic inflammatory response syndrome(SIRS) caused by infection.It can develop to multiple organ dysfunction syndrome,which is the main cause led to death.It is very important for diagnosing sepsis and identifying prognosis and improving survival rate to early differentiate the infectious SIRS from the noninfectious SIRS.Now often applied lab diagnostic index of sepsis include C-Reactive Protein(CRP), Procalcitonin(PCT),White blood Cell Count(WBC) and Blood Culture.While Interleukin-2(IL-2),Interleukin-4(IL-4),Interleukin-6(IL-6),Interleukin-10(IL-10), Tumor Necrosis Factor-α(TNF-α) and Interferon-γ(IFN-γ) are cytokines,which have many biological functions and can provide beneficial evidence for clinical diagnosis.In this research,on studying the dynamic level of IL-2,IL-4,IL-6,IL-10,TNF-α, and IFN-γin sepsis,we can explore clinical significance of serum cytokines on diagnosis in children with sepsis. Methods:Totally 30 children with sepsis from December 2007 to September 2008 in Pediatric Intensive Care Unit(PICU) of Children's Hospital Affiliated to ZheJiang University School of Medicine were chosen.Among them,male 17 cases and female 13 cases,age(4.28±3.10),weight(9.16±6.24 kg).Protopathy included severe bronchopneumonia 13 cases,enteritis 4 cases,dermal infection 6 cases,purulent tonsillitis 2 cases,severe scald complicated infection 2cases and purulent meningitis 3cases.Routine infection determine were tested at admission,48h,96h.The serum level of IL-2,IL-4,IL-6,IL-10,TNF-α,an IFN-γwere determined by FACSCALIBUR Flow Cytometry.The serum level of PCT is tested by CBRTHOLD.The serum level of CRP is tested by Orion Diagnostica.WBC is measured by ABBOTT CELL-DYN 3700.Stastistical treatment:Use SPSS10.0 package to analysis all the data.The data in the experiment will be expressed in the form of Mean±Standard deviation((?)±s).The changes indicators before and after treatment will be testified by t-test,in which significant difference are indicated if P＜0.05.Pearson Correlate analysis will be employed to analyze correlation between IL-2,IL-4,IL-6,IL-10,TNF-α,IFN-γand CRP,PCT,WBC.Results:(1) With PICS increase,the serum level of IL-2,IL-4,IL-6,IL-10,TNF-α,IFN-γis decreasing.(2) There were significant positive correlation between serum level of IL-6 and CRP,PCT,WBC(r=0.927,0.883,0.517,P＜0.05).There were significant positive correlation between serum level of IL-10 and CRP, PCT,WBC(r=0.869,0.938,0.891,P＜0.05). There were significant positive correlation between serum level of TNF-αand CRP, PCT,WBC(r=0.857,0.897,0.866,P＜0.05).There is no significant correlation between serum level of IL-2,IL-4,IFN-γand CRP,PCT,WBC.(3) The serum level of IL-2,IL-4,IL-6,IL-10,TNF-α,IFN-γ,CRP,PCT and WBC decreased slowly,accompanied by sepsis recover.Especially The serum level of IL-6, L-10,TNF-αdecreased distinctly(P＜0.05).Conclusion:(1) Determination of IL-2,IL-4,IL-6,IL-10,TNF-αand IFN-γlevel could be used as the diagnosis index in sepsis.(2) Determination of IL-6,IL-10,and TNF level may be valuable in assessing the therapy effect of the children with sepsis.