全身炎症反应综合征患者血脂变化与炎症反应的相关性研究  

Correlation between the changes of lipids and the inflammatory reaction in the patients with systemic inflammatory response syndrome

作　　者：裘力锋[1] 许国根[1] 吴锦鸿[1] 顾清[1] 缪群[1] 陈雯[1] 

机构地区：[1]杭州市第一人民医院急诊科,310006

出　　处：《中国急救医学》2007年第5期401-403,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的观察全身炎症反应综合征(SIRS)患者血浆高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、总胆固醇(TC)、三酰甘油(TG)和肿瘤坏死因子(TNF-α)水平的变化,探讨血脂变化在炎症反应中的意义。方法符合SIRS诊断48例,分别在入院后第1、3和第5天清晨空腹抽肘静脉血3mL,测定HDL、LDL、TC、TG和TNF-α,并设对照组。结果SIRS患者血浆HDL、LDL、TC、TG入院后各监测点均比对照组显著下降(P<0.01,P<0.05),HDL入院第3天为最低,并且降低更为显著(P<0.01)。SIRS患者TNF-α入院后各监测点均比对照组显著升高(P<0.05,P<0.01)。HDL、LDL、TC、TG与TNF-α具有相关性(P<0.05,P<0.01)。结论机体过度炎症反应时,HDL、LDL、TC、TG水平下降,并且与炎症反应的程度密切相关,可作为评估预后的一个参考指标;在治疗原发病的基础上,提高血脂和脂蛋白水平,有助于缓解病情,改善预后。Objective To investigate the changes of high - density lipoprotein （HDL） , low - density lipoproteln （ LDL ） , total cholesterol （ TC ） , trigeminal ganglion （ TG ） and tumor necrosis factor -α （ TNF -α） in plasma of patients with systemic inflammatory response syndrome （ SIRS ） , and to evaluate the significance of changes of lipids in the inflammatory reaction. Methods 48 patients diagnosed as SIRS were included in the experimental group, the healthy people were in the control group. 3 - mL blood was drawn from elbow vein in each patient respectively on the 1st, 3rd and 5th day＇s mornings after their admission. Plasma HDL, LDL, TC, TG and TNF - α were detected. Results HDL, LDL, TC and TG were lower in patients with SIRS during observation periods than in the control group （ P 〈 0. 01, P 〈 0. 05 ）. HDL was the lowest on the 3rd day and decreased significantly [ P 〈0.01 ）. TNF -α was higher in the experimental group during observation periods than in the control group （ P 〈 0. 05, P 〈 0.01 ）. There was a significant correlation between HDL, LDL, TC, TG and TNF-α （P 〈0. 05, P 〈0.01 ）. Conclusion The levels of HDL, LDL, TC and TG were decreased when excessive inflammatory reaction happened, and it has significant relationship with the degree of the inflammatory reaction. It could be a parameter to assess the prognosis. To elevate the levels of lipids and lipoprotein besides the treatment of the primary disease may be beneficial to the control of SIRS and the improvement of prognosis.

关 键 词：全身炎症反应综合征 血脂 脂蛋白 炎症反应 

分 类 号：R459.7[医药卫生—急诊医学]