关键词: 脓毒症, 白介素1受体1, 活性蛋白C, 降钙素原, 儿童

Abstract: Objective　To investigate the clinical value of serum interleukin-1 receptor 1（IL-1R1），active protein C（APC），and procalcitonin（PCT） for evaluating the severity of pediatric sepsis.Methods　Sixty-six children，38 with sepsis and 28 with severe sepsis，treated in the ICU of the Children's Hospital of Hebei province in 2015 were included.Thirty healthy children who presented for routine examinations during the study period were the control group.Serum IL-1R1，APC，and PCT were assayed in patients within 24 hours of admission and in controls on enrollment.Receiver operating characteristic（ROC） curve were used to evaluate the significance of IL-1R1，APC，and PCT as markers of sepsis severity.Results　There were significant differences in the IL-1R1，APC，and PCT concentrations（all P<0.05）．IL-1R1 and PCT were higher in the sepsis group than in the control group，and APC was significantly lower（P<0.05）．IL-1R1 was higher，and APC was lower，in the severe sepsis group than in the control group（P<0.05）．APC was higher in the severe sepsis group than in sepsis group（P<0.05）．PCT was higher in the severe sepsis group than in both sepsis and control groups（P<0.05）．The area under the ROC curve（AUC） of the IL-1R1 concentration for diagnosing severe sepsis was 0.597，which was not significantly different from 0.500（P=0.198）．The corresponding AUCs of APC and PCT were 0.686 and 0.817，respectively（both > 0.500；P=0.013 for APC and P<0.001 for PCT）．The AUC of the three combined markers was 0.834，which was significantly higher than 0.500（P<0.001）．Conclusion　Elevated serum PCT and the three biomarkers combined were relatively accurate in evaluating the severity of sepsis and have potential clinical value as a reference of severity.

Key words: Sepsis, IL-1R1, APC, PCT, Child