Detection of circulating histone H4 in children under one year old with sepsis / 中国小儿急救医学

ABSTRACT

Objective To identify the differences of circulating histone H4 (hH4) levels in different phrase of children under 1 year old with sepsis, investigating its possible role in the process of sepsis. Methods We retrospectively analyzed 40 sepsis patients aged between 1 and 12 months old who were ad-mitted in PICU of Shenzhen Maternity and Children Healthcare Hospital between November 2016 and December 2017. Their clinical data were reviewed,and then they were categorized into three groups,non-criti-cal group(n=21),critical group(n=11) and extremely critical group(n=8) by Pediatric Critical Illness Score ( PCIS) . Forty children of the same age group with no signs of infection were enrolled as control group. Plasma from 4 groups on admission day and the third day after admission were collected. Plasma hH4 levels of all samples were measured and all parameters were reconfigured and statistically analyzed. Results HH4 levels of samples were collected from sepsis group on admission daynon-critical group (97. 22 ± 16. 92)μg/L,criti-cal group (148. 09 ± 33. 00)μg/L,extremely critical group (195. 04 ± 45. 85)μg/L. HH4 levels of all three sub groups were significantly higher than those of control group [(46. 07 ± 18. 06)μg/L, H = 64. 16, P<0. 001]. Data of the third day were as follownon-critical group (98. 96 ± 16. 29)μg/L,critical group (152. 57 ± 29. 04)μg/L,extremely critical group (239. 52 ± 49. 84)μg/L. Comparing the parameters of the first and the third admission day,hH4 levels of both non-critical group (Z= -1. 42,P=0. 16) and critical group (Z= -1. 48,P=0. 14) showed no significant difference. However,hH4 levels of extremely critical group were significantly increased on the third admission day (Z= -2. 67,P=0. 008). Setting the discharge day or the seventh day after admission as the endpoint of the observation, hH4 levels of the death group [241. 53(229. 19,245. 07)μg/L]were significantly higher than that of the survival group[115. 21(96. 38,136. 15)μg/L,Z= -2. 80,P=0. 005]. Among the sepsis,hH4 levels were negatively correlated with their PCIS results on admission day(r= -0. 853,P<0. 001). The hH4 levels were also negatively correlated with the patients'PCIS score changes on the third day after admission(r = -0. 554,P <0. 001). Conclusion The levels of circulating hH4 in sepsis children are co-related to the prognosis and severity suggesting that it may affect the process of the sepsis in certain ways.