低血容量性休克早期患者血浆白细胞介素-1活性变化及其机制的分析  

Alteration in plasma interleukin-1 activity in patients with hypovolemic shock and its mechanism

作　　者：石汉平[1] 齐德林[1] 黄祥成[1] 徐洁[2] 杨瑞和[2] 

机构地区：[1]广州第一军医大学南方医院普外科,广州510515 [2]上海长海医院急诊科,上海200433

出　　处：《中国危重病急救医学》1998年第3期167-169,共3页Chinese Critical Care Medicine

基　　金：全军九五指令性攻关课题

摘　　要：目的；观察低血容量性休克早期患者血浆IL－1活性的变化及其与β－内啡肽（β－EP）、内毒素的关系。方法：患者从受伤至入院后平均50分钟采血样，血浆IL－1、β－EP和内毒素分别采用改良LAF法、放射免疫法和显色基质偶氮法测定。结果：休克患者血浆IL－1活性显著高于对照组，其中死亡患者又显著高于存活患者；休克患者血浆β－EP含量与对照组比较有显著增加，且与IL一1活性密切相关，但存活与死亡患者之间无明显差异；存活患者血中内毒素水平无明显变化，而死亡患者则显著升高，与IL－1活性也呈显著正相关。结论：低血容量性休克患者早期血浆IL－1活性升高，其机制可能与β－EP升高有关；死亡患者外周血内毒素水平上升，可能是造成其血浆IL－1活性更为增加的重要原因。Objective: To observe the change in plasma interleukin - 1 (IL -l) activity and its relation to β - endorphine (β - EP) content and endotoxin level in patients with hypovolemic shock. Methods:Blood samples were collected in trauma patients about 50 minutes after injuries. Plasma IL - 1,β- EP and endotoxin were assayed by LAF, radioimmunoassay and limulus test, respectively. Results: Asignificant elevation in plasma IL - 1 activity was observed in patients with hemorrhage compared withnormal controls,and IL - 1 activity was much higher in dead cases than in survivors. Meanwhile,plasmaβ - EP was markedly increased in patients after hypovolemic shock,and it was closely related to IL - 1activity. No significant difference in plasma β- EP was found between survivors and non - survivors (P>0. 05). In addition,there was no marked increase in plasma endotoxin level in survivors,but it was significantly elevated in non -- survivors and positively correlated with plasma IL - 1 activity. Conclusions:Plasma IL - 1 activity appears to be remarkably increased at the early stage of hypovolemic shock,whichis associated with β - EP formation. Elevation of circulating endotoxin levels may be an important factorcontributing to marked release of IL - 1 in patients with fatal outcome.

关 键 词：低血容量性休克 TL-1 Β-内啡肽 内毒素 

分 类 号：R605.971[医药卫生—急诊医学]