严重多发伤患者血浆TNF-α动态变化及临床意义  

The Change of plasma levels of TNF-α and its clinical significance in patients with severe multiple trauma

作　　者：王白云[1] 吴礼平[1] 候立力[1] 廖谷清[1] 梁娜[1] 

机构地区：[1]南华大学附属南华医院,湖南衡阳421002

出　　处：《海南医学》2007年第6期15-16,共2页Hainan Medical Journal

摘　　要：目的探讨严重多发伤患者血浆TNF-α动态变化以及与APACHEⅡ评分相关性。方法运用酶联免疫分析法(ELISA)测定36例严重多发伤患者伤及12例体检健康者血浆TNF-α的水平。同时对36例多发伤患者进行APACHEⅡ评分。结果多发伤患者血浆TNF-α水平显著高于正常对照组(P<0.01);多发伤合并多脏器功能障碍综合征(MODS)患者血浆TNF-α水平及APACHEⅡ评分显著高于未合并MODS(非MODS)患者(均P<0.01);死亡组血浆TNF-α水平及APACHEⅡ评分显著高于存活组(均P<0.05);血浆TNF-α水平与APACHEⅡ评分呈显著正相关(r=0.837P<0.01)。结论严重多发伤患者血浆TNF-α水平与APACHEⅡ评分有良好的相关性;测定TNF-α水平有助于判断预后,对早期诊断MODS可起预警作用。Abstract Objective To detect the change of the plasma levels of tumor necrosis factor-α （TNF-α） in patients with severe multiple trauma and the correlation with APACHE Ⅱassessment. Methods Plasma TNF-α levels were measured using enzyme linked immunoadsorbent assay （ELISA） and APACHE Ⅱ score were also assessed in 36 patients with severe multiple trauma. Results Plasma TNF-α levels of patients with severe multiple trauma were markedly higher than those of controls （P〈0.01）. TNF-α levels and APACHE H in MODS group significantly increased than non-MODS group （P〈0.01）. TNF-α levels and APACHE Ⅱ of non-survivors were significantly higher than those of controls （P〈0.05）. Plasma TNF-α levels in patients were positively related to their APACHE Ⅱ assessment （r=0. 837 P〈0. 01 ）. Conclusions TNF-α levels provide early diagnosis for patients with MODS and also provide prognosis for patients with severe multiple trauma.

关 键 词：多发伤 肿瘤坏死因子-Α 急性生理和既往健康评分 

分 类 号：R446.1[医药卫生—诊断学]