全身炎症反应综合征患者核因子-κB活性与预后的关系  

Correlation between nuclear factor kappaB activation and prognosis in patients with systemic inflammatory response syndrome

作　　者：杨光田[1] 刘德红[1] 李树生[1] 刘纯钢[1] 占成业[1] 房明浩[1] 祝伟[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院急诊科,武汉430030

出　　处：《中华急诊医学杂志》2005年第1期57-60,共4页Chinese Journal of Emergency Medicine

基　　金：湖北省科技攻关项目 ( 2 0 0 3AA3 0 1C5 1)

摘　　要：目的　观察全身炎症反应综合征 (SIRS)患者核因子 κB (NF κB)的活性、白介素 6 (IL 6 )水平及急性生理与慢性健康评分Ⅱ (APACHEⅡ )的变化 ,探讨NF κB活性与SIRS患者病情及预后的关系。方法　将 35名SIRS患者按MODS的诊断标准和疾病的转归分别分成多器官功能障碍综合征组 (MODS组 )和非MODS组 ,存活组和死亡组 ;选择健康体检者 2 0例作为对照组。检测外周血单个核细胞NF κB的活性及血浆IL - 6水平 ,并进行APACHEⅡ评分。结果　SIRS患者的NF κB活性和IL 6水平明显高于对照组 (P<0 0 1) ;NF κB活性 ,IL 6水平和APACHEⅡ评分在MODS组和死亡组分别明显高于非MODS组和存活组(P <0 0 1或P <0 0 5 ) ;NF -κB活性与IL - 6水平及APACHEⅡ评分均呈明显正相关 (r =0 75 4 ,r =0 737,P <0 0 1) ;IL - 6水平与APACHEⅡ评分呈明显正相关 (r=0 6 35 ,P <0 0 1)。结论　NFObjective To observe the changes of nuclear factor Kappa B (NF-κB), interleukin-6 (IL-6)and acute physiology and chronic health evaluationⅡ (APACHEⅡ) scores in patients with systemic inflammatory response syndrome(SIRS), and to study the role of NF-κB in estimating the severity of illness and prognosis.Methods Thirty five patients in the intensive care unit (ICU) were in the trial group, and 20 healthy people were in the control group. Thirty five patients were divided into multiple organ dysfunction syndrome (MODS) group and non - MODS group according to the MODS diagnostic criterion, and they also were followed-up for 28 days and then assigned to the group of survivors and non - survivors based on their prognosis. The activation of NF-κB was measured by immunohistochemical method, and the level of IL-6 were examined by enzyme-linked immunosorbent assay(ELISA) in each patient at 1, 3,the 5 and 7 days. APACHEⅡ scores were calculated for each patient during the first 24h in the ICU.Results The activations of NF-κB and the level of IL-6 in patients with SIRS were higher than those in control group (P<0.01). The activations of NF-κB, the level of IL-6 and APACHEⅡ scores in the MODS group and the non - survivors group were higher than those in non - MODS group and the survivors group (P<0.01 or P<0.05). There were obvious positive correlations between the activations of NF-κB and the level of IL-6 and APACHEⅡscores (r=0.754,r=0.737,respectively, P<0.01), and also good positive correlation between the level of IL-6 and APACHEⅡscores (r= 0.635,P<0.01). Conclusion The activation of NF-κB has a close relationship with the severity and the prognosis in patients with SIRS.

关 键 词：患者 IL-6 SIRS APACHEⅡ评分 全身炎症反应综合征 核因子-κB 预后 活性 存活 疾病 

分 类 号：R365[医药卫生—病理学]