Changes in lipid metabolism in pediatric patients with severe sepsis and septic shock
Changes in lipid metabolism in pediatric patients with severe sepsis and septic shock
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DOI：
10.1016/j.nut.2017.09.015
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发表时间：
2018-03-01
期刊：
影响因子：
4.4
通讯作者：
Delgado, Artur F.
中科院分区：
文献类型：
--
作者：
Bermudes, Ana Carolina G.;de Carvalho, Werther B.;Delgado, Artur F.
目的：关于全身炎症反应综合征危重患儿的血脂谱知识有限。本研究的目的是评估严重脓毒症/感染性休克的儿科重症监护病房（PICU）收治的危重儿科患者的炎症反应强度和血脂谱变化之间的关系：这是一项前瞻性和观察性研究，在一所公立大学医院的15张病床的PICU。我们分析了40例严重脓毒症/脓毒性休克患者在住院第一天和第七天入住PICU的血脂谱。C-反应蛋白被用作全身炎症的标志物。42例儿科患者看到在急诊科和全身炎症反应综合征被用来提供控制values.Results：在第1天入院的PICU，患者有显着降低水平的总胆固醇（TC），高密度脂蛋白（HDL），低密度脂蛋白（LDL），以及较高浓度的三酰甘油与对照组相比。从研究第1天到第7天，TC、HDL、LDL和载脂蛋白水平显着增加。结论：在严重脓毒症/脓毒性休克期间，我们发现血清脂蛋白和载脂蛋白水平较低，并且这些与C反应蛋白呈负相关。随着炎症反应的改善，TC、HDL、LDL和载脂蛋白水平升高，表明脂质谱变化与炎症之间存在直接关系。(C)2017爱思唯尔公司All rights reserved.
Objectives: Limited knowledge exists regarding the lipid profiles of critically ill pediatric patients with systemic inflammatory response syndrome. The aim of this study was to evaluate the relationship between the intensity of the inflammatory response and changes in the lipid profiles of critically ill pediatric patients admitted to a pediatric intensive care unit (PICU) with severe sepsis/septic shock.Methods: This was a prospective and observational study at a 15-bed PICU at a public university hospital. We analyzed the lipid profiles of 40 patients with severe sepsis/septic shock admitted to the PICU on the first and seventh days of hospitalization. C-reactive protein was used as a marker for systemic inflammation. Forty-two pediatric patients seen in the emergency department and without systemic inflammatory response syndrome were used to provide control values.Results: On day 1 of admission to the PICU, the patients had significantly lower levels of total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) as well as higher concentrations of triacylglycerols compared with the control group. There was a significant increase in the TC, HDL, LDL, and apolipoprotein levels from day 1 to day 7 of the study.Conclusions: During severe sepsis/septic shock, we found lower serum levels of lipoproteins and apolipoproteins, and these were negatively correlated with C-reactive protein. As the inflammatory response improved, the levels of TC, HDL, LDL, and apolipoproteins increased, suggesting a direct relationship between changes in the lipid profiles and inflammation. (C) 2017 Elsevier Inc. All rights reserved.