The changes of serum cortisol,pro‐B‐type natriuretic peptide and interleukin‐6 in critically ill children with stress / 中国小儿急救医学

ABSTRACT

Objective To understand the changes of the levels of serum cortisol,pro‐B‐type natri‐uretic peptide(Pro‐BNP) and interleukin‐6(IL‐6) in the critical stress children. Methods The experimental group enrolled the children with severe infection,polytrauma and cardiopulmonary resuscitation admitted in PICU of Children′s Hospital of Fudan University from May 2015 to December 2015. The children admitted to the surgical ward during the same period without trauma,infection,heart,kidney and adrenal diseases or dys‐function,and without a long history of glucocorticoid use were selected as the control group. According to the pediatric critical illness score(PCIS),the experimental group was divided into 3 subgroupssevere critically ill group(PCIS≤70,n＝17),critically ill group(PCIS 71‐89,n＝26),and non‐critically ill group( PCIS≥90,n＝15). What′s more,the experimental cases were divided into survival group (n＝39) and death group ( n＝19) according to the prognosis. On the day of admission and during the period with stable condition,the peripheral blood sample were collected to detect serum cortisol,Pro‐BNP and IL‐6. While the control cases were detected the same items on the day of admission or pre‐operation. Results The concentrations of serum cortisol,Pro‐BNP and IL‐6 on the day of admission in severe critically ill group,critically ill group and non‐critically ill group were higher than those in the period with stable condition (P<0. 05). The concentrations of serum cortisol, Pro‐BNP and IL‐6 on the day of admission in control group, non‐critically ill group, critically ill group and severe critically ill group increased in sequence (P<0. 05). While in stable condition, there were no statistically significant differences among severe critically ill group,critically ill group and non‐critically ill group( P >0. 05). The concentrations of Pro‐BNP and IL‐6 in death group were significantly higher than those in survival group(P<0. 05). While the level of cortisol showed no statistically significant difference between death group and survival group( P>0. 05). PCIS was negatively correlated with serum cortisol,Pro‐BNP and IL‐6 (r＝ －0. 571,－0. 661 and －0. 504,P<0. 05,respectively). Conclusion The levels of serum cortisol,Pro‐BNP and IL‐6 in critically ill children all significantly increase in acute critically ill period,which are all negatively correlated with PCIS. They can be used as the indicators of severity of ill‐ness. Pro‐BNP and IL‐6 also can be used as the indicators of the prognosis of disease.