多发伤合并多器官功能障碍综合征患者血浆TNF-α和IL-10水平测定的临床意义  

Serum level of TNF-α,IL-10 in multitrauma patients with multiple organ dysfunction syndrome

作　　者：蔡华波[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院危重病科,杭州310016

出　　处：《浙江医学》2005年第9期654-656,共3页Zhejiang Medical Journal

摘　　要：目的探讨肿瘤坏死因子-α(TNF-α)、白介素-10(IL-10)在多发伤合并多器官功能障碍综合征(MODS)患者中的变化特点以及其意义。方法将56例多发伤患者按照是否合并MODS分为两组,在受伤后第1、3、5、7天抽取静脉血,应用双抗体夹心ELISA法检测TNF-α、IL-10水平,比较两组间和组内各时间点TNF-α、IL-10的水平,并以14例健康体检者的测定结果作为对照。结果合并MODS组伤后第1、3、5、7天的TNF-α水平和IL-10水平与对照组比较,差别都有显著性意义(均P<0.05);未合并MODS组伤后第1、3、5、7天的TNF-α水平与对照组比较,差别都有显著性意义(均P<0.05),IL-10水平在伤后第1天明显提高(P<0.05),但是第3、5、7天的IL-10水平与对照组比较,差别无显著性意义(P>0.05)。两组多发伤患者的TNF-α水平和合并MODS组的IL-10水平在伤后第3、5、7天较第1天明显升高(均P<0.05),而未合并MODS组IL-10水平在第3、5、7天的水平较第1天明显下降(均P<0.05),但是两组多发伤患者各自第7天的TNF-α水平与第5天比较,差别无显著性意义(均P>0.05)。多发伤合并MODS组TNF-α、IL-10水平与未合并MODS组比较在伤后第1、3、5、7天都有明显的升高(均P<0.05)。结论血浆TNF-α和IL-10水平的检测对判断多发伤患者的疾病严重程度、病情发展趋势和MODS的发生都有重要的意义,而IL-10可以用于评价全身炎症反应综合征的严重程度。Objective To determine the changes of the serum levels of tumor necrosis factor（TNF-α）, and interlukin-10（IL-10） in multitrauma patients with multiple organ dysfunction syndrome（MODS） and compare the relationship between the muhitrauma patients with MODS and without MODS. Methods The serum levels of TNF-α and IL-10 were measured in 56 multitrauma patients on day 1,3,5,7 after injured .56 patients were divided into with MODS group and without MODS group, and compared the levels of TNF-α and IL-10 between two groups. Results The serum levels of TNF-α and IL-10 on different times in multitrauma patients with MODS were higher than those of in control（P〈0.05）, and the serum levels of TNF-α on different times in muhitrauma patients without MODS were higher than that of in control （P〈0.05）, the serum level of IL-10 on 1 day after injury in multitrauma patients without MODS were higher than that of in control （P〈0.05）, but those on 3,5,7 day were not higher than that of in control（P〉0.05）o The serum levels of TNF-α and IL-10 at every time period in patients with MODS were higher than those in patients without MODS, but the levels of IL-10 in multitrauma patients without MODS were lower after injury. The levels of TNF-α in multitrauma patients with MODS group, without MODS group and the levels of IL-10 in multitrauma patients with MODS were higher after injury, Conclusion Determining the serum levels of TNF-α and IL-10 in multitrauma patients with MODS is helpful in judging the severity of injury, whether or not complicating with MODS.

关 键 词：肿瘤坏死因子 白介素-10 多发伤 多器官功能障碍综合征 IL-10 血浆TNF 水平测定 肿瘤坏死因子-α(TNF-α) 伤患者 临床意义 

分 类 号：R641[医药卫生—外科学]