Expression Of Plasma Monocyte Chemotactic Protein-1 In Children With Sepsis And Study Of The Effect Of Myocardial Injury

Objective:To evaluate the expression of plasma monocyte chemotactic protein-1 in children with sepsis and relationship of myocardial injury's severity.Methods:According to the international sepsis criteria 62 critically ill patients admitted to the department of paediatrics were classified into four groups:Infection (25) sepsis (17), severe sepsis (12) and septic shock (8), with 50 healthy individuals as control groups. The level of plasma monocyte chemotactic protein-1 was measured in each group, and compared with the other biomarkers of myocardial injury (hs-CRP,CK-MB,cTnl), monocyte chemotactic protein-1 was detected using a new sandwich immunoassay.Results:Monocyte chemotactic protein-1 concentration was 52.89ng/L for Infection, 146.40 ng/L for sepsis,321.06 ng/L for severe sepsis and 480.43 ng/L for septic shock, the plasma concentration of monocyte chemotactic protein-1 exhibited a gradual increase, and the monocyte chemotactic protein-1 value was greatest in the septic shock group. Comparing with the other biomarkers of myocardial injury, in the sepsis, severe sepsis and septic shock group, the plasma concentration of monocyte chemotactic protein-1 in the nonsurvivors was significantly greater than in the survivors (P< 0.05), and the difference in monocyte chemotactic protein-1 values was clear on the first day of admission to the department of paediatrics (P< 0.05). By the receiver operating characteristic (ROC) plot analysis of monocyte chemotactic protein-1 in sepsis patients, the area under the ROC curve for monocyte chemotactic protein-1 was similar to the area under the ROC curve for cTnI and was significantly higher than the area under the ROC curve for hs-CRP and CK-MB.Conclusion:The measurement of monocyte chemotactic protein-1 has great clinical value in the early specifical diagnosis of myocardial injury and risk assessment in sepsis.