Determination Of Plasma Cortisol Levels In Children With Sepsis And Its Clinical Significance

Objective: To determine the levels of early plasma cortsol(COR)in children with sepsis and to analyze the relationship between plasma cortisol levels and the severity and prognosis of the disease.Methods: Collected data of 40 children with sepsis from June 2016 to December 2017 at the affiliated hospital of North Sichuan Medical College,and according to the severity of the disease were divided into general sepsis group(n = 22)and severe sepsis group(n = 18).Plasma cortisol levels and WBC,PLT,PCT,CRP,LAC and other indicators were monitored early in the disease.Control group of 20 patients admitted to hospital with non-sepsis.To analyze the relationship between plasma cortisol levels and other infectious indicators in children with sepsis and its value in determining severity and prognosis.Results:1.The average level of plasma cortisol in children with severe sepsis was(43.58 ± 18.66)?g/dl,which was significantly higher than that of the general sepsis group(21.62 ± 10.83)?g/dl and the non-sepsis group(10.01 ± 3.26l)?g/dl,the differences were statistically significant,the plasma cortisol levels in children with general sepsis were higher than non-sepsis group,the difference was statistically significant.2.The differences of WBC,PCT,LAC,UREA,CR,CK-MB and ALT between severe sepsis group and general sepsis group were statistically significant,the difference of CRP,GLU and PLT between the two groups was no significant difference statistical significance.3.Plasma cortisol levels were positively correlated with lactate levels(r = 0.361,p=0.022),but not with PCT,CRP and WBC(p> 0.05).4.According to prognosis,severe sepsis patients were divided into death group and survival group,The average level of plasma cortisol in death group was(49.76 ± 14.71)?g/dl,higher than that in survival group(41.20 ± 19.98)?g/dl,but p> 0.05,the difference was not statistically significant.Conclusion: The early plasma cortisol levels was elevated and was associated with the severity and prognosis of the disease in children with sepsis,the more serious the disease,the more obvious increase in cortisol.In this study,the number of cases with obvious decrease in cortisol was only 1,and the sample size was small,it was not possible to accurately assess the occurrence of adrenal insufficiency in sepsis,so,corticosteroids should be used sparingly in clinical practice.