title: [Changes in serum cortisol and adrenocorticotropic hormone in children with sepsis shock and their clinical significance].
abstract: OBJECTIVE
  To study the changes in serum levels of cortisol and adrenocorticotropic hormone (ACTH) in children with septic shock (SS) and to explore their relationship with the disease severity and prognosis.
  
  
  METHODS
  Twenty-five children with decompensated SS and 24 children with early SS were enrolled. Serum cortisol and ACTH levels were determined on admission and days 3 and 8 after admission. Twenty-five healthy children were used as the control group. The children with decompensated SS were further divided into death group (n=5) and survival group (n=20) based on their clinical outcome.
  
  
  RESULTS
  On admission, the decompensated SS and early SS groups had significantly higher serum cortisol and ACTH levels than the control group (P<0.05), and the decompensated SS group had significantly higher serum cortisol and ACTH levels than the early SS group. On day 3 after admission, the decompensated SS group had significantly higher serum cortisol and ACTH levels than the early SS and control groups (P<0.05), and the early SS group had a significantly higher serum ACTH level than the control group (P<0.05). Among the children with decompensated SS, the death group had significantly higher serum cortisol and ACTH levels than the survival group on admission (P<0.01); on day 3 after admission, the death group still had a significantly higher serum cortisol level than the survival group (P<0.01).
  
  
  CONCLUSIONS
  Children with SS have increased serum cortisol and ACTH levels, which are associated with the disease severity. A persistent high serum cortisol level indicates a poor prognosis. Dynamic monitoring of serum cortisol and ACTH levels in children with SS is of great significance in evaluating the disease severity and prognosis.
authors.affiliation: Department of PICU, Fujian Maternal and Child Health Care Hospital /Teaching Hospital of Fujian Medical University, Fuzhou 350001, China. linhai652@163.com.
authors.forename: Hai
authors.initials: H
authors.lastname: Lin
authors.forename: Zi-Jing
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Shi-Biao
authors.initials: SB
authors.lastname: Wang
authors.forename: Yu-Lan
authors.initials: YL
authors.lastname: Kang
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007223:Infant; D008297:Male; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone