多器官衰竭患者血中肿瘤坏死因子与纤维连结蛋白的动态观测及临床意义  

changes of plasma tumor necrosis factor andfibronectin in patients with multiple organfailure

作　　者：黄志红[1] 徐世豪[1] 董德耀 王兰[1] 颛孙奕奕 

机构地区：[1]解放军第304医院

出　　处：《中国危重病急救医学》1994年第4期205-207,共3页Chinese Critical Care Medicine

摘　　要：对１７例已发生多器官衰竭（ＭＯＦ）的患者，于发病后第１～２０天分别进行血浆肿瘤坏死因子（ＴＮＦ）与纤维连结蛋白（ｆｎ）的动态观测。结果：①全部患者病程各时间点的血浆Ｆｎ均值均低于正常值（２５２．１２±２４．７２ｍｇ／Ｌ），ＴＮＰ均值则明显高于正常值（５．５０±０．２７ｕｇ／Ｌ）。②ＭＯＦ发生５天内Ｆｎ均值波动下降，第６天有明显回升达正常界限，第７天降低后再度明显回升，但于第１０天又见下降而后波动在１８０．００～２３０．００ｍｇ／Ｌ。③ＴＮＦ均值在ＭＯＦ发生５天内逐日上升，达到４５．００１ｕｇ／Ｌ，而后虽有一定波动，但基本持续在３２．００ｕｇ／Ｌ以上。作者认为：与正常人比较，ＴＮＦ的增高变化比Ｆｎ降低变化更为明显，且较稳定，故作为诊断参考指标１ＮＦ比Ｆｎ更有价值。Plasma tumor necrosis factor (TNF)andfibonectin (Fn)were determined simultaneously andsequentially 1-20 days after the episode of multipleorgan failure(MOF)in 17 patients.The average val-ue of was lower and TNF was higher in MOF Pa-tients during the whole course of the disease than those in the healthy controls.The average value ofFn was found to be decreasing within 5 days after theepisode of M OF, and markedly increased to thenormal range by the 6th day,It was marketlyreincreased after its decrease on the 7th day.Again itwas found to be decreasing on the 10th day,and fluc-tuating in a range of 180-230 mg/L from that dayon.The average value of TN F was found to beincreasing within 5 days after the episode of M OF,reaching up to 45μg/L,and thereafter retained at alevel over 32μg/LaIthough a certain fluctuationcould be seen,It is considered that the increase ofTNF is mote obvious and stable than the decrease ofFn jn patients with MOFas compared to normal in-dividuals.Henve , as a dignositic indicator , TN F ismore valuable than Pn.

关 键 词：肿瘤坏死因子 多器官衰竭 蛋白 FN 

分 类 号：R590.2[医药卫生—内科学]