Applied Research On Angiopoietin2 In Sepsis And Lung Injury Of Pediatric Patients

Objective: This study was to measure the plasma Ang2 in sepsis and ALI/ ARDS expression level in children; To explore the respiratory between Ang2 levels in evaluating sepsis condition and significance of lung injury severity and prognosis.Methods: Using prospective observational study methods,screening 141 consecutive PICU admissions during the study period of July,2013 to December,2014 at Hunan Children’s Hospital were enrolled in the study.Patients with cancer, chronic lung disease, chronic kidney disease, and vasculitis were excluded.At the same time, in the case of parents informed consent,select a total of 20 cases of children in the children’s hospital of hunan province of Child care division.Using quantitative enzyme-linked immunosorbent method to detect the plasma Ang2 level, at the same time to complete other biochemical index testing and shall. According to the clinical registration of designed by ourselves, collectingthe clinical data, biochemical, organ function and prognosis,LIS,PCIS score. According to the "international pediatric sepsis consensus",the 141 children were divided into sepsis group(n = 99) and severe sepsis group(n = 42, including septic shock),survival group(n = 114) and death group(n=27). In severe sepsis group,according to The 2012 Berlin diagnostic criteria,divided into the lung injury group(n = 30) and the lung injury group(n = 12).Results:1.Severe sepsis group Ang2 level higher than sepsis group.Death group admission Ang2 median level 17.44 ng/ml,survival group Ang2 median level 11.76ng/ml,death group is significantly higher than survival group,the difference is statistically significant.Plasma level of Ang2 and viscera function index,cereal third transaminase(ALT),aspertate aminotransferase(AST),urea nitrogen(BUN), creatinine(Cr),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CK- MB),troponin(c Tn I) changes;Biochemical index increased with the increased group comparison,Ang2 levels increased significantly.Assessment on the level of plasma Ang2 severe sepsis area under the ROC curve was 0.80(95% CI: 0.724,0.883),with Ang2 level is 14.21 ng/ml in the diagnosis of severe sepsis,sensitivity was 82.5%, specificity was 68.4%.2.According to the The 2012 Berlin diagnostic criteria the severe sepsis group including 42 children were divided into ARDS group(n = 30) and no ARDS group(n = 12). ARDS group Ang2 the median level 19.19 ng/ml, group without ARDS Ang2 the median level 14.81 ng/ml,rather than the group without without ARDS was 14.81ng/ml, the difference was statistically significant.17.24 ng/ml for Ang2 the sensitivity of the diagnosis of lung injury was 76.7%,specificity 79.3%, the area under the ROC curve was 0.83(95% CI: 0.763, 0.904),showing that the Ang2 has certain diagnostic value.Conclusion:1. The plasma Ang2 significantly increased in Children with severe sepsis, death group significantly higher than the survival group.2. The Plasma Ang2 could be used to assess the condition of septic patients,and dynamic test plasma Ang2 can help to predict septic patients’ prognosis.3. sepsis with pulmonary injury in children the plasma Ang2 concentration increased significantly,death group significantly higher than the survival group. The plasma Ang2 levels are available to assist in sepsis with pulmonary injury.