创伤患者血浆肿瘤坏死因子-α、白细胞介素-4动态变化及其意义  

作　　者：白黎智[1] 邢嵘[1] 路小光[1] 康新[1] 

机构地区：[1]辽宁省大连大学附属中山医院急救医学科,116000

出　　处：《中国实用医药》2007年第15期22-24,共3页China Practical Medicine

摘　　要：目的探讨创伤后血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)的变化规律及其临床意义。方法创伤患者35例,分别于伤后24h内、3、5、7d取血,采用酶联免疫吸附法(ELISA)测定血浆白细胞介素-4(IL-4)和肿瘤坏死因子-α(TNF-α)含量,并分析IL-4和TNF-α水平以及TNF-α/IL-4比值与患者伤情、严重并发征及预后的关系。结果创伤患者血中TNF-α含量于伤后第5天起开始下降,至第7天最明显;伤后血中IL-4含量呈现波动性上升;TNF-α/IL-4比值呈持续性下降,其中MODS组下降较非MODS组显著(P<0.05);TNF-α/IL-4比值与APACHE-Ⅱ评分呈负相关(r=-0.622,P<0.05),与患者感染率呈显著负相关(r=-0.868,P<0.01)。结论创伤应激后可出现TNF-α/IL-4持续性下降,与患者的免疫机能、预后情况密切相关。Objective To evaluate the clinical significance of the shift plasma of TNF-α/ IL-4 cytokines in patients after trauma. Methods Thiry-five patients with mechanical injury were investigated. Blood collection was started 24 h after injury ,and blood samples were obtained at 3、5、7 d post-trauma in 35 cases respectively. The plasma levels of IL-4 and TNFαwere measured by enzyme-linked immuno-sorbent assay(ELISA) . The relationship was analyzed between the levels of TNFα、IL-4、TNF-α/ IL-4 and APACHEⅡscore ,complications and prognosis in patients. Results The drop of the level of blood TNF-αbegan at 5 d post-trauma and peaked at 7 d post-trauma. The level of plasma IL-4 fluctuated and increased after trauma. The ratio of TNF-α/ IL-4 decreased successively ,and the ratio in patients with MODS was significantly lower than that without MODS(P< 0. 05) . Furthermore ,the ratio was correlated negatively with APACHEⅡscore (r =-0. 622 ,P< 0. 05) ,and significantly correlated negatively with the rate of infection(r=-0.868, P< 0. 01) .Conclusion The drop of TNF-α/ IL-4 appeared after trauma ,which was closely correlated with immunological function and prognosis.

关 键 词：创伤 肿瘤坏死因子-Α 白细胞介素-4 血浆 

分 类 号：R641[医药卫生—外科学]