严重多发伤患者血清酶含量及血液炎症因子动态变化及其临床意义  

Dynamic Changes of Myocardial Enzyme Series,PCT,TNF-α and IL-6 and Its Clinical Significance in Patients with Severe Multiple Trauma

作　　者：叶恭水[1] 丁宁[1] 陈晓雄[1] 

机构地区：[1]北京同仁医院,北京100730

出　　处：《实用预防医学》2009年第4期1054-1056,共3页Practical Preventive Medicine

摘　　要：目的探讨严重多发伤后血清酶含量及血液炎症因子动态变化及其临床意义。方法对142例多发伤患者分别在伤后第1、3、5、7和14d检测血清CPK、LDH、ALT、AST的含量及血浆PCT、血清TNF-α、IL-6浓度水平变化,分别根据ISS评分和预后情况分组,比较检测结果。结果⑴严重伤组伤后第1dCPK、AST、ALT、LDH均有不同程度上升,均明显高于与轻伤组同期指标(P<0.01或P<0.05);⑵轻伤组患者伤后第3d起血浆PCT浓度测定均无明显升高,严重伤组患者血浆PCT浓度自发病起始终于高水平范围内波动,两组差异有统计学意义(P<0.01或P<0.05);严重伤组TNF-α、IL-6在第3d已开始升高,均明显高于轻伤组同期指标(P<0.01或P<0.05);⑶死亡组血清酶和炎症因子的浓度水平均明显高于存活组(P<0.01)。结论严重多发伤后血清酶含量及炎症因子水平升高显著,在一定程度上能反应体内炎症反应程度,监测严重多发伤患者的血清酶、PCT、TNF-α及IL-6水平有助于判断疾病的发展及顸后。Objective To investigate the dynamic changes of myocardial enzyme series, PCT, TNF - α and IL - 6 in patients with severe multiple trauma so as to explore its clinical significance. Methods Totally 142 patients with severe multiple trauma were divided into different groups; prognosis, the concentrations of myocardial enzyme series, PCT, TNF - α and IL - 6 in these patients were measured at the 1^st, 3^rd, 5^th, 7^th, 14^th days after trauma. Results The myocardial enzyme series level was significantly increased at the first day after trauma in severe degree group which were significantly higher than those in mild degree group （P〈 0.01 or P〈 0;05）. The level of PCT in mild degree group was not increased at the 3^rd day after trauma and the level of PCT in severe degree group always kept high. There was statistically significant difference between the two groups （P〈 0.01 or P〈 0.05）. The concentrations of TNF-α and IL- 6 in severe degree group were significantly increased at the 3^rd day after trauma which were higher than those in mild degree group（ P〈 0.01 or P 〈 0.0.5）. The concentrations of myocardial enzyme series, PCT, TNF- α, and IL- 6 in death group were significantly higher than those in living group （P〈 0.01）. Conclusions Myocardial enzyme series, PCT, TNF- α, and IL- 6 are involved in the pathological process of multiple trauma and might be relevant with severe multiple trauma.

关 键 词：严重多发伤 血清酶 PCT TNF—α IL-6 

分 类 号：R641[医药卫生—外科学]