多发伤患者血浆白介素10水平与创伤严重度和临床预后的关系  

The relationship of plasma interleukin 10 levels to severity of injury and clinical outcome in polytrauma patients

作　　者：徐祥[1] 梁华平[1] 罗艳[1] 耿波[1] 陈方祥[1] 王正国[1] 高劲谋 都定元[1] 李邦春[1] 夏爱莲[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所,重庆400042 [2]重庆市急救中心创伤研究所,重庆400014

出　　处：《感染．炎症．修复》2001年第3期139-143,共5页Infection Inflammation Repair

摘　　要：目的:研究严重多发伤患者血浆IL-10的变化及其与创伤严重度和临床预后的关系。方法:应用ELISA方法检测30例ISS≥16分的多发伤患者伤后血浆IL-10水平的变化,并与正常对照比较。以ISS≥25分为界把患者分成低ISS组(L-ISS)和高ISS组(H-ISS),比较两组血浆IL-10水平变化规律。另外,将16例H-ISS患者分存活、局部感染、脓毒症、SIRS、ARDS及MODS六组,比较各组间IL-10含量的变化。结果:在伤后0～21天观察期间多发伤患者血浆IL-10明显升高,伤后早期血浆IL-10水平与ISS评分呈正相关。并发SIRS、局部感染、脓毒症、MODS的患者伤后早期IL-10水平较无并发症患者、死亡患者较存活者呈不同程度升高。结论:伤后早期IL-10水平变化与患者创伤严重度和临床预后相关。Objective: To study the change in plasma interleukin 10 (IL-10) levels and its relationship with severity of injury and clinical outcome in severe polytrauma patients. Methods: Using enzyme-linked immunosorbent assay, we observed the changes in IL-10 in plasma from 30 patients with severe polytrauma (ISS≥16) and 11 healthy controls. Patients were divided into two groups (high ISS and low ISS) according to ISS, and difference of plasma IL-10 levels between two groups were compared. In addition, according to survival or complications, including systemic inflammatory response syndrome (SIRS), localized infection, sepsis, multiple organ dysfunction syndrome (MODS), adult respiratory distress syndrome (ARDS), 16 high ISS patients were divided into two groups, and difference of plasma IL-10 levels between two groups were compared. Results; Plasma IL-10 levels in polytrauma patients were significantly elevated throughout the observation period of 21 days compared with that of healthy volunteers, and plasma IL-10 levels were correlated with severity of injury inthe early stage after trauma. Patients who died from injury or developed posttraumatic complications (SIRS, localized infection, sepsis, MODS) showed elevated IL-10 levels in comparison with injured patients without posttraumatic complications. Conclnsions: Changes in plasma IL-10 level in the early stage after trauma collaborate with severity of injury and clinical outcome in polytrauma patients.

关 键 词：多发伤 白细胞介素-10 临床预后 

分 类 号：R64[医药卫生—外科学]