血清细胞因子与APACHEⅡ评分的变化在严重创伤患者监测中的意义  

Significance of serum cytokines concentrations and APACHE scores in evaluating the illness state for Critical patients

作　　者：曾晖[1] 阮少川[1] 蔡立华[1] 江东新[1] 覃丙军[1] 杨宇清[1] 袁肖媚[1] 

机构地区：[1]东莞市人民医院 ICU,广东省东莞523018

出　　处：《中国基层医药》2006年第8期1252-1253,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨血细胞因子与APACHEⅡ评分的变化在严重创伤患者病程监测中的意义。方法本组患者36例,采用自身对照的方法,按照入院时急性生理学和慢性健康状况评分(APACHEⅡ评分)分为轻度创伤组和重度创伤组,分别在入院的第1、3、5、7天动态检测血清肿瘤坏死因子α(TNF-α)、白介素6(IL-6)的变化,并同步进行APACHEⅡ评分,所得结果进行统计学分析。结果患者入院时轻度创伤组与重度创伤组比较血清TNF-α、IL-6水平差异有统计学意义。轻度创伤组患者TNF-α水平在第1、3、5、7天渐下降,血IL-6水平在第7天开始下降,APACHEⅡ评分也逐渐下降；重度创伤组患者血TNF-α、IL-6水平以及A- PACHEⅡ评分虽经治疗仍持续上升,两组比较差异有统计学意义。结论动态测定严重创伤患者血TNF-α、IL-6水平结合APACHEⅡ同步评分,更有助于准确及时地评估病情和判断预后。Objective To investigate the clinical significance of serum cytokines concentrations and APACHE scores in evaluating the illness state for critical trauma patients. Methods A clinical prospective self-control trial was performed,in which 36 patients admitted to ICU by SIRS were enrolled. Objects were divided into mild and severe trauma group according to APACHE score. The TNF-a and IL-6 concentrations were determined on the 1st, 3rd and 5th day of admission, the APACHE score were assessed at the same time. Statistic analysis was performed according to this group. Results The TNF-a concentrations decreased continuously in the following days while IL-6 decreased from the 7th day in the mild trauma group. In the severe trauma group the TNF-a and IL-6,APACHE score concentrations kept increasing. There was a significant difference of TNF-a and IL-6 concentrations between severe trauma and mild trauma group. Conclusion Dynamic measurement of TNF-a and IL-6 concentrations with APACHE score provide great help to evaluate the illness stare and predict the prognosis.

关 键 词：全身炎症反应综合征 APACHE Ⅱ评分 白细胞介素6 肿瘤坏死因子α 

分 类 号：R641[医药卫生—外科学]