Abstract: Objective　To study the clinical application value of level of neutrophil extracellular traps (NETs) in the severity evaluation of sepsis in children. Methods　A total of 53 children with sepsis in Children's Hospital Affiliated to Zhengzhou University from October 2019 to June 2021 were selected as a sepsis group [29 males and 24 females, with an age of (2.07±0.68) years old], and 53 children with healthy physical examination were selected as a healthy group [33 males and 20 females, with an age of (1.83±0.59) years old] in a 1:1 ratio. Blood samples were collected and tested for NETs level. The levels of NETs in the two groups, the levels of NETs in children with different degrees of sepsis, at different time points, in different periods, and with different prognosis, and the correlation were analyzed. χ² test was used for the count data, independent sample t test was used for the measurement data, and Spearman correlation analysis was used. Results　The level of NETs in the sepsis group was significantly higher than that in the healthy group [(42.41±4.34)% vs.(0.26±0.04)%], with a statistically significant difference (P<0.001). The levels of NETs in 6 children with severe sepsis were significantly higher than that in 43 children with general sepsis [(57.82±6.19)% vs.(40.11±4.08)%], with a statistically significant difference (P<0.001). On the first day and the seventh day, the level of NETs in children in infection stage was significantly higher than that in children in infection dissipation stage (both P<0.001). The level of NETs in the 14 dead cases was significantly higher than that in the 39 survivors [(59.56±5.35)% vs.(33.56±3.46)%], with a statistically significant difference (P<0.001). Spearman analysis showed that the level of NETs was significantly positively correlated with infection stage (r=0.581) and death (r=0.623) (both P<0.001). Conclusions　Timely monitoring of NETs level during the treatment of children with sepsis can identify the stage of disease, and the effectiveness of treatment regimens can be determined according to the trend of changes in NETs level, which is convenient for clinicians to adjust medication regimens in time and improve clinical efficacy. In addition, NETs level detection can also predict the risk of prognosis to provide individualized preventive measures, which has a high application value.

Key words: Sepsis, Neutrophil extracellular traps, Prognosis

摘要： 目的　研究中性粒细胞胞外诱捕网（NETs）水平在脓毒症患儿病情评估中的临床应用价值。方法　选取2019年10月至2021年6月郑州大学附属儿童医院脓毒症患儿53例作为脓毒症组［男29例，女24例；年龄（2.07±0.68）岁］，并以1∶1配比选取53例健康体检患儿作为健康组［男33例，女20例；年龄（1.83±0.59）岁］，均采集血液样本，行NETs水平检测，分析两组NETs水平及不同病情程度脓毒症患儿NETs水平、不同时间点不同时期NETs水平、不同预后NETs水平、相关性。计数资料采用χ²检验，计量资料采用独立样本t检验，采用Spearman进行相关性分析。结果　脓毒症组患儿的NETs水平明显高于健康组［（42.41±4.34）%比（0.26±0.04）%］，差异有统计学意义（P<0.001）。6例脓毒症严重患儿的NETs水平明显高于47例一般患儿［（57.82±6.19）%比（40.11±4.08）%］，差异有统计学意义（P<0.001）。入院第1天、入院第7天，感染期患儿NETs水平明显高于感染消散期，差异均有统计学意义（均P<0.001）。14例死亡者NETs水平明显高于39例存活者［（59.56±5.35）%比（33.56±3.46）%］，差异有统计学意义（P<0.001）。Spearman分析结果显示，NETs水平和感染期、预后死亡呈明显的正相关（r=0.581、0.623，均P<0.001）。结论　在脓毒症患儿治疗期间及时监测NETs水平可鉴别病情时期，依照NETs水平变化趋势可明确治疗方案的有效性，便于临床医生及时调整用药方案，提高临床疗效，且NETs水平检测还可对预后转归风险进行预判，予以个体化预防措施，应用价值较高。

关键词: 脓毒症, 中性粒细胞胞外诱捕网, 预后