在患有急性生理压力的儿科患者中,血清皮质醇的预测因素:一个队列研究
Shogo Akahoshi1,2, Marie Mitani-Konno1, Taku Murakami3
1Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
概括
在急性压力期间的儿童皮质醇水平受到心率,温度和年龄的影响. 早期采样和更高的儿科早期预警系统分数也预测了儿童的皮质醇升高.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 临床化学 临床化学
- 关键护理医学 关键护理医学
背景情况:
- 皮质醇测量对于评估压力患者的上腺功能至关重要.
- 皮质醇水平可能受到许多临床变量的影响,使解释复杂化.
- 识别皮质醇变化的预测因素对于小儿病患者的准确临床评估至关重要.
研究的目的:
- 确定患有急性生理压力的儿科患者血清皮质醇水平的独立预测因子.
- 探索各种临床因素与重症儿童皮质醇度之间的关联.
主要方法:
- 一项前性研究涉及217名入院于一般或儿科重症监护病房的儿科患者.
- 血清皮质醇水平在入院72小时内测量.
- 使用混合效应模型进行多重回归分析,以确定皮质醇水平的预测因子.
主要成果:
- 总共分析了397个样本,其中皮质醇水平的中位数为375nmol/L.
- 高皮质醇水平的重要预测因素包括心率z-score升高,体温和儿科早期预警系统得分.
- 年龄较小 (3-6岁),提前采样时间 (注册后<4小时),以及早晨采样 (6-10 AM) 也与皮质醇水平较高有关.
结论:
- 心率z-score,体温,儿科早期预警系统得分,年龄,经过的时间和采样时间是急性生理压力下的儿科患者皮质醇水平的独立预测指标.
- 这些发现有助于解释重症儿童的皮质醇测量.
- 了解这些预测因素可以改善儿科压力场景中的上腺功能的临床评估.
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