创伤患者血浆干扰素-γ、白介素-4动态变化及其意义  

Clinical significance of shift of plasma IFN-γ、IL-4 cytokines in patients after trauma

作　　者：李斌[1] 文亮[1] 刘明华[1] 孙薇[1] 

机构地区：[1]第三军医大学西南医院急救部,重庆400038

出　　处：《创伤外科杂志》2004年第4期266-268,共3页Journal of Traumatic Surgery

摘　　要：目的　探讨创伤后血浆干扰素 γ(IFN γ)、白介素 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 2 4小时内、3、5、7天取血 ,采用酶联免疫吸附法 (ELISA)测定血浆白介素 4 (IL 4 )和干扰素 γ(IFN γ)含量 ,并分析IL 4和IFN γ水平以及IFN γ/IL 4比值与患者伤情、严重并发症及预后的关系。结果　创伤患者血中IFN γ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 ;IFN γ/IL 4比值呈持续性下降 ,其中MODS组下降较非MODS组显著 (P <0 .0 5 ) ;IFN γ/IL 4比值与APACHEⅡ评分呈负相关 (r=- 0 .6 2 2 ,P <0 .0 5 ) ,与患者感染率呈显著负相关 (r=- 0 .86 8,P <0 .0 1 )。结论　创伤应激后可出现IFN γ/IL 4持续性下降 ,与患者的免疫机能。Objective To evaluate the clinical significance of the shift plasma of IFN γ/IL 4 cytokines in patients after trauma.?Methods Thiry five patients with mechanical injury were investigated.?Blood collection was started 24h after injury,and blood samples were obtained at 3、5、7d post trauma in 35 cases respectively.?The plasma levels of IL 4 and IFN γ were measured by enzyme linked immuno sorbent assay(ELISA).?The relationship was analyzed between the levels of IFN γ、IL 4、IFN γ/ IL 4 and APACHEⅡ score,complications and prognosis in patients.?Results The drop of the level of blood IFN γ began at 5d post trauma and peaked at 7d post trauma.?The level of plasma IL 4 fluctuated and increased after trauma.?The ratio of IFN γ/ 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 APACHEⅡ score(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 IFN γ/IL 4 appeared after trauma,which was closely correlated with immunological function and prognosis.

关 键 词：创伤 干扰素-Γ 白介素-4 血浆 

分 类 号：R641[医药卫生—外科学]