创伤后血浆肿瘤坏死因子-α、白介素-4动态变化及其意义  

Clinical significance of the shift of plasma IFN-γ and IL-4 cytokines in patients after trauma

作　　者：毛瑞军[1] 孙强[1] 

机构地区：[1]大连大学附属中山医院,辽宁大连116001

出　　处：《现代医药卫生》2006年第24期3715-3717,共3页Journal of Modern Medicine & Health

摘　　要：目的:探讨创伤后血浆肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)的变化规律及其临床意义。方法:创伤患者35例,分别于术后24小时内、3、5、7天取血,采用酶联免疫吸附法(ELISA)测定血浆白介素-4(IL-4)和肿瘤坏死因子-α(TNF-α)含量,并分析IL-4和TNF-α水平以及TNF-α/IL-4比值与患者伤情、严重并发症及预后的关系。结果:创伤患者血中TNF-α含量于伤后第五天起开始下降,至第七天最明显;伤后血中IL-4含量呈现波动性上升;TNF-α/IL-4比值呈持续性下降,其中MODS组下降较非MODS组显著(P<0.05);TNFα/IL-4比值与APACHEⅡ评分呈负相关(r=-0.622,P<0.05),与患者感染率呈显著负相关(r=-0.868,P<0.01)。结论:创伤应激后可出现TNF-α/IL-4持续性下降,与患者的免疫机能、预后情况密切相关。Objective：To evaluate the clinical significance of the shift of plasma of TNF-α and IL-4 cytokines in patients after trauma.Methods：Thiry-five patients with mechanical injury were investigated.Blood collection was started 24 hours after injury,and blood samples were obtained at 3,5,7days post-trauma in 35 eases respectively.The plasma levels of IL-4,TNFαwere measured by enzymelinked immuno-sorbent assay （ELISA）.The relationship was analyzed between the levels of and TNFedIL-4 and APACHE Ⅱ score,complications and prognosis in patients.Results：The drop of the level of bloodTNFαbegan at 5days post-trauma and peaked at 7days post-trauma.The level of plasma IL-4 fluctuated and increased after trauma.The ratio of TNFα IL-4 decreased successively,and the ratio in patients with MODS was significantly lower than that without MODS （P〈0.05）.Furthermore,the ratio was correlated negatively with APACHE Ⅱ score （r=-0.622,P〈0.05）,and significantly correlated negatively with the rate of infection（r=-0.868, P〈0.01）.Condusion：The drop of TNFα IL-4 appeared successively after trauma,which was closely correlated with immunological function and prognosis.

关 键 词：创伤 肿瘤坏死因子-Α 白介索-4 血浆 

分 类 号：R6[医药卫生—外科学]