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Abstract：
Objective: The aim of this study was to investigate the level of resistin in children with and without sepsis hospitalized in the pediatric intensive care unit (PICU) and compare them to levels in healthy subjects in order to determine the trend of resistin levels in children in PICUs and also to identify the cut-off values for positive sepsis. Methods: This was a case-control study conducted in 2014 at a children\'s hospital in Tabriz, Iran. Three groups were investigated, a case group comprised of patients with sepsis admitted to PICU and two control groups; one made up of patients admitted to PICU without sepsis and the other of healthy children. Variables included demographic, anthropometric (growth metric percentile), and clinical factors. Results: Patients were randomized into control group A (n = 12, 48%), control group B (n = 11, 44%), and the sepsis group (n = 24, 47.1%). The difference in the means of resistin levels was significant on the first, fourth, and seventh days (P < 0.0001) in the case and control group A. Means comparisons in the case and control group B revealed significant differences on the fourth and seventh day (P = 0.005 and P < 0.0001, respectively) but not on the first day (P = 0.246). The trend of resistin levels increased in the septic group (F Huynh-Feldt = 37.83, P < 0.0001). The diagnostic accuracy of resistin level was high for discriminating sepsis (area under the receiver operating characteristic curve [AUC] 0.864 [SE = 0.41]). The sensitivity was 0.824 and specificity 0.72 with a cut-off point of 5.2 ng/ml on the first day. Conclusion: In the present study, resistin level can be used as an indicator of sepsis in children admitted to PICU. However, the cut-off point based upon when a prediction could be made is different and is dependent on a variety of factors, such as control group and number of days since the first signs of sepsis.
摘要：
目的：本研究的目的是调查在儿科重症监护病房（PICU）住院的有或无脓毒症儿童的抵抗素水平，并将其与健康受试者的水平进行比较，以确定儿童抵抗素水平的趋势在PICU中并确定败血症阳性的临界值。方法：这是2014年在大不里士一家儿童医院进行的病例对照研究，伊朗。调查了三组，病例组由PICU收治的脓毒症患者和两个对照组组成;一个由未发生脓毒症的PICU患者和另一个健康儿童组成.变量包括人口统计，人体测量学(生长度量百分位数)，和临床因素。结果：患者随机分为对照组A（n=12，48％），对照组B（n=11，44%），和脓毒症组（n=24，47.1%）。抵抗素水平的均值差异在第一个是显著的，第四,病例组和对照组A的平均值比较显示第4天和第7天存在显著差异(分别为P=0.005和P<0.0001),但第1天没有显著差异(P=0.246)。脓毒症组抵抗素水平有升高趋势(FHuynh-Feldt=37.83,P<0.0001)。抵抗素水平对脓毒症的诊断准确性很高（受试者工作特征曲线下面积[AUC]0.864[SE=0.41]）。第一天的敏感性为0.824，特异性为0.72，临界点为5.2ng/ml。结论：在本研究中，抵抗素水平可作为PICU患儿脓毒症的指标。然而,基于何时可以进行预测的截止点是不同的，并且取决于各种因素，例如对照组和自出现脓毒症症状以来的天数。
