内皮细胞损伤与器官功能不全的关系  

Relationship of vascular endothelial dysfunction to the patients with systemic inflammatory response syndrome and multiple organ dysfunction syndrome

作　　者：李毅贤[1] 李春盛[1] 

机构地区：[1]首都医科大学附属北京朝阳医院急诊科,北京100020

出　　处：《中国急救医学》2006年第1期22-25,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨血管内皮细胞功能状态在SIRS和MODS发生发展中的变化及其作用。方法动态观察SIRS及非SIRS患者外周血一氧化氮(NO)、内皮素(ET-1)、组织纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)、循环内皮细胞(CEC),并予Marshall评分。结果ET-1、PAI-1、CEC在SIRS组、MODS亚组、死亡亚组均显著升高(P<0.05)。NOt、-PA在SIRS组、MODS亚组、死亡亚组均显著降低(P<0.05)。Marshall评分在SIRS组、MODS亚组、死亡亚组均显著增高(P<0.05)。结论内皮细胞的损伤表现为ET-1、PAI-1、CEC增加,NOt、-PA减少,内皮细胞损伤在SIRS发展演变为MODS过程中起主要作用。Marshall评分对于器官功能不全的评估是敏感指标。Objective To inquir＇e into relationship of vascular endothelial dysfunction to the patients with systemic inflammatory response syndrome（SIRS） and multiple organ dysfunction syndro,ne（MODS）. Methods Plasma levels of tissue plasminogen activator（t- PA）, plasminogen- activator inhibitor- I（PAI - 1）, circulation endothelial cell（CEC） and serum levels of endothelin（ ET- 1 ）, nitric oxide （NO） were determined in all the patients dynamically and in healthy pc,sons, and at the same time the patients were evaluated with muhiple organ dysfunction score. Results Blood levels of ET - 1, PAI- 1, CEC were significantly high in the SIRS group, MODS group and no - survivor group, Blood levels of NO, t - PA were significantly low in the SIRS group, MODS group and nosurvivor group. Multiple organ dysfunction score was high in SIRS group, MODS group and no - survivor group. Conclusions There are endothelial dysfunctions in the patients with SIRS; Measuring CEC and the markers of injured vascular endothelium dynamically may be. good way in evaluating the prognosis of patients with SIRS; Multiple organ dysfunction score is sensitive parameters in evaluating the patients with MODS.

关 键 词：多脏器功能不全综合征 全身炎症反应综合征 内皮细胞功能障碍 

分 类 号：R363[医药卫生—病理学]