Changes of thrombomodulin and P-selectin in newborn infants with septicemia / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate the changes of thrombomodulin (TM) and P-selectin(P-sel) in neonates with septicemia and to explore their significances in evaluating the patient's condition and prognosis.Methods From Jun.2010 to Mar.2012,56 neonates with septicemia were included in the septicemia group.And 26 healthy neonates were selected as the control group.The neonatal critical illness scores(NCIS) of septicemia were recorded after hospitalization.According to the scores of NCIS,the neonates were divided into extremely critical group(n =13),critical group (n =22),and non-critical group (n =21).Plasma samples of septicemia groups were taken on admission and in the recovery stages.Plasma samples were taken only once in the control group.The plasma TM and P-sel were measured by enzyme-linked immuno sorbent assay.The TM and P-sel levels were compared among different groups.Results The TM levels in extremely critical group,critical group and non-critical group were (25.52 ± 6.57) μg/L,(17.31 ±4.74) μg/L and (13.27 ± 2.83) μg/L,respectively,which were significantly higher than those in the control group [(9.82 ± 2.69) μg/L] (allP'＜ 0.01).The P-sel levels in extremely critical group,critical group and non-critical group were (162.51 ± 52.64) μg/L,(131.10 ± 38.61) μg/L,(78.18 ± 32.15) μg/L,respectively,which were significantly higher than those in the control group [(61.51 ± 21.35) μg/L] (all P ＜ 0.01).The plasma TM and P-sel levels in non-critical group,critical group and extremely critical group were gradually increased (all P ＜ 0.05).The levels of TM and P-sel in the recovery stage were (10.48 ± 3.44) μg/L and (67.52 ± 25.03) μg/L,respectively,which were significantly decreased compared with those before treatment(all P ＜ 0.01).There was no statistically significant difference in TM and P-sel between the Gram negative bacteria infection group and the Gram positive bacteria infection group (all P ＞ 0.05).The prothrombin time and activated partial thromboplastin time in extremely critrcal group were increased than those of other groups (all P ＜ 0.01).The plasma D-dimer levels in non-critical group,critical group and extremely critical group were increased gradually(all P ＜0.01).NCIS was negatively correlated with TM and P-sel(r =-0.428,-0.515,all P ＜ 0.01).Conclusion The detection of TM and P-sel may be helpful in evaluating the severity and prognosis of disease in neonates with septicemia.