急性毒鼠强中毒患者血清β-EP、ET、NO与TNF的动态变化  

The variations of serum β-endorphin,endothelins,nitrogen monoxide and tumor necrosis factor in acute tetramethylene-disulfo-tetramine poisoning

作　　者：张在其[1] 彭巍[1] 翁志华[1] 杨华喜[1] 郑大伟[1] 尹芙蓉[1] 王承志[1] 刘仁水[1] 刘嗣庭 罗正平[1] 

机构地区：[1]湖南省怀化市第二人民医院急诊科,怀化418200

出　　处：《中华急诊医学杂志》2004年第11期774-777,共4页Chinese Journal of Emergency Medicine

摘　　要：目的　研究血清 β 内啡肽 (β EP)、内皮素 (ET)、一氧化氮 (NO)与肿瘤坏死因子 (TNF)在急性毒鼠强中毒患者病程中动态变化及其临床意义。方法　 4 8例急性毒鼠强中毒患者分别在入院后即刻、中毒后 1、 3、 5、 7、 9、 11、 13、 15、 17、 19d抽静脉血 2ml,测定血浆中的 β EP、ET、NO与TNF ;以30名健康者为对照。结果　①在 4 5例治愈患者中 ,β EP、ET、NO与TNF在轻、中、重三组均于入院后即刻非常显著性升高 ,于中毒后 1d达高峰 ,随后缓慢下降。β EP恢复正常时间在轻、中、重三组分别为中毒后 9、 13、 17d。ET恢复正常时间在轻、中、重三组分别为中毒后 7、 13、 15d。NO恢复正常时间在轻、中、重三组分别为中毒后 7、 11、 11d。TNF恢复正常时间在轻、中、重三组分别为中毒后 9、 11、 17d。②3例死亡者β EP、ET、NO与TNF在入院后即刻均已非常显著性升高 ,在治疗过程中继续升高。 结论　①血清 β EP、ET、NO与TNF水平与急性毒鼠强中毒程度及病情转归相关。②血清 β EP、ET、NO与TNF水平在治疗过程中稳定下降提示预后良好 ,而其持续升高提示预后不良。③采取相应措施降低 β EP、ET。Objective To study the dynamic variations of serum β-endorphin(β-EP),endothelins(ET),nitrogen monoxide (NO)and tumor necrosis factor (TNF)and their clinical significiances in acute tetramethylene-disulfo-tetramine poisoning.Methods Forty_eight patients with tetramethylene-disulfo-tetramine poisoning were enrolled in this study.Their β-EP,ET,NO and TNF were measured upon at hospitalization and 1 d,3 d,5 d,7 d,9 d,11 d,13 d,15 d,17 d,19 d after poisoning,and compared with 30 healthy individuals.Results ①The levels of β-EP,ET,NO and TNF from 45 patients who were cured were significantly higher than those of healthy individuals at hospitalization,peaked at 1d after poisoning in the mild,moderate and severe groups.The time for β-EP returned to normal was at 9 d,13 d and 17 d after poisoning in the mild,moderate and severe groups respectively.The time for ET returned to normal level was at 7 d,13 d and 15 d after poisoning in the mild,moderate and severe group srespectively.The time for NO returned to normal was at 7 d,11 d,and 11 d after poisoning in the mild,moderate and severe groups respectively.The time for TNF returned to normal level was all at 9 d,11 d and 17 d after poisoning in the mild, moderate and severe groups,respectively.②The levels of β-EP,ET,NO and TNF of 3 patients who died finally were very high at hospitalization and continued to increase in the course of treatment.Conclusion ①The levels of β-EP,ET,NO and TNF correlated with the severity and the patients cause in tetramethylene-disulfo-tetramine poisoning ②The levels of β-EP,ET,NO and TNF decreased gradually indicating eusemia in the course of treatment, on the contrary,their levels increased gradually indicating mal-prognosis ③ To lower levels of β-EP,ET,NO and TNF with corresponding measures could alter the prognosis of tetramethylene-disulfo-tetramine poisoning.

关 键 词：TNF ET Β-EP 急性毒鼠强中毒 患者 正常 血清 动态变化 恢复 下降 

分 类 号：R595.4[医药卫生—内科学] R714[医药卫生—临床医学]