| Objective: Systemic inflammatory response syndrome (SIRS) is a clinical severe disease that is inflammatory of total body caused by kinds of infectious or noninfectious major injury. It's parenchyma is imbalance and disorder of the immunity caused by excessively inflammatory medium releasing. Lots of experiments confirmed that lipopolysa- ccharide (LPS), lipopolysaccharide binding protein(LBP)/CD14 take part in the process of inflammatory pathophysiology.LPS is one of the major agent which can induce uncontrolled inflammatory reaction, and LBP/CD14 are the main agent of body identification and regulation to the action of LPS,and can highly rise most cells' sensitivity to LPS,which increased the LPS activity hundreds or thousands folds,thus guide cells response to trace endotoxin. The increasing effect of LBP/mCD14 to LPS will enlarge the inflammatory reaction in cascade mod, and can formatted vicious cycle ,finally would lead to septic shock and multiple organ dysfunction syndrome(MODS). At present,lots of investigation were performed in the role of LBP/CD14 to LPS actions in internal or at abroad, but most of them areanimal experiments, and nearly no any clinical detections. Furthermore,it hasn't any report about blood LPS level and the expression of LBP/mCD14 in normal children and children with SIRS. My experiment determinated the blood LPS concentration and the expression of LBP/mCD14 in 30 SIRS patients,and compared with 21 mormal children,to clarification the alteration in inflammatory of the three substances above mentioned to try to find the role of these matters in the occurrence and development of SIRS,which has very important clinical significance in assisting to seek therapeutic measures to SIRS,to intervent SIRS reasonablely, and to prevent the occurrence of MODS. Methods: We selected 30 SIRS patients randomly in our wards from September, 2001 to September, 2002 according to the diagnosis standard proposed by Hayden ,and suggested on the second Globe ICU conference of Pediatrics in Dutch Rotterdam in 1996, and basing on the correlation diagnosis standard to make the clinical staging and the diagnosis of MODS. According to their illness, patients have corresponding bacteria cultivation of blood, pharyngoswab or the stool, and detect the serum specific antibody of Herpes simplex virus, Coxsackie virus, Adenovirus, Rubella virus,Respiratory syncytical virus by ELISA methods. The 21 in the normal control team were healthy children to have physical checking at the same time. The two teams have no significantly statistic difference in the distribution of sex andage. We collected venous blood of 4 millilitre from all the children,and quantitative determination blood LPS, LBP, mCD14 by limulus reagent kinetic turbimetric assay, flow cytometry technique and ELISA method. After being checking-out by normal distribution, the numer of blood LPS,LBP,mCD14 of the two teams is described by mean±standard deviation.All datas are analyzed with SAS 8.0. Comparison of blood LPS or LBP concentration between the two teams adopt the proximitly t＇test, comparison of mCD14 between the two teams used the t test. Correlation between LPS and LBP,mCD14 used the liner correlation analysis. The siganificant level is α = 0.05. Result: 1. Blood LPS concentration: The concentration in children with SIRS is 0.618±0.229EU/ml,the healthy children of the normal controls is 0.044±0.018EU/ml,the t＇test show P＜0.05.Result above indicated that blood concentrations in SIRS patients are much higher than the level in healthy children. 2.Result of mean fluorescence intensity(MFI) of mCD14 on monocytes: the MFI of mCD14 on monocytes in the SIRS patients is 1249.448±252.430,the healthy children in the normal controls is 802.916±181.234,t test show P<0.05, which indicated that mCD14 expression on monocytes in SIRS patients is increased compared with the healthy. 3. The serum LBP concentration: Tthe SIRS patients' is 266.108±120.916nmol/ml,while the normal controls' is 106.45±20.176nol/ml,t＇test show P... |
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