血清血管性血友病因子在不同中医证型脓毒症中的变化  

Changes of serum von Willebrand factor in septic patients with different traditional Chinese medicine syndromes

作　　者：许雅萍[1] 杨敏春[1] 张召才[2] 蔡国龙[2] 胡才宝[2] 钱沈京[1] 严静[2] 

机构地区：[1]浙江医院中医科,浙江杭州310013 [2]浙江医院ICU,浙江杭州310013

出　　处：《中国中西医结合急救杂志》2009年第4期211-213,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省中医名科重症感染专科建设项目（22）;浙江省中医药科技计划项目（2006C022,2007YB034,2009ZA011）

摘　　要：目的探讨脓毒症内皮细胞功能在中医证型动态整体观察中的意义。方法将68例脓毒症住院患者按中医卫气营血辨证方法分为气分证组（23例）、营分证组（28例）、血分证组（17例）；以26例非脓毒症患者作为对照组。分别取各组患者空腹股静脉血，用放射免疫法检测血清血管性血友病因子抗原（vWf：Ag）、肿瘤坏死因子-α（TNF—α）、白细胞介素-6（IL-6）、IL-2、IL-4和白细胞计数（WBC）。结果除IL-2外，脓毒症组所有参数值均显著高于对照组（P均〈0．05）。血分证组vWf：Ag水平明显高于营分证组[（178．6±51．8）％比（129．1±28．7）％，P〈0．053。脓毒症各组间，营分证组IL-4、WBC均高于气分证组，血分证组WBC高于营分证组（P均〈0．05），而TNF-α、IL-6、IL-2各脓毒症组间比较差异无统计学意义。结论脓毒症vWf水平随着中医证型的变化而变化;动态观察vWf水平可作为脓毒症辨证的相关参考指标。Objective To study the changes and clinical significance of the serum levels of von Willebrand factor （vWF） in septic patients with different traditional Chinese medicine （TCM） syndromes. Methods The femoral fasting blood samples were consecutively collected from 26 non-septic control patients and 68 septic patients. By TCM syndrome differentiation of Wei Qi Ying and Xue （卫气营血）, the hospitalized septic patients were divided into Qi-fen group （气分证, 23 cases）, Ying-fen group （营分证, 28 caese） and Xue-fen group （血分证, 17 cases）. Serum vWf ：Ag, tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6）, IL-2, IL-4 and white blood cell count （WBC） were measured by radioimmunoassay. Results The levels of TNF-α and IL-6 in the septic group were significantly higher than those in the control group （all P〈0. 05）. The vWf：Ag level in Xue-fen group was obviously higher than that in Ying-fen group C（178.6±51.8） % vs. （129.1±28. 7）%, P〈0. 053. IL-4 and WBC in Ying-fen group were significantly higher than those in Qi-fen group, and WBC in Xue-fen group was obviously higher than that in Ying-fen group （all P〈0. 05）. The TNF-α, IL-6 and IL-2 levels in septic patients with different TCM syndromes had no statistical difference. Conclusion Along with the changes of TCM syndrome, the serum vWf level is also altered in septic patients dynamic observation of serum vWf level may be a related reference criterion for TCM syndrome differentiation of sepsis.

关 键 词：脓毒症 血管性血友病因子 辨证论治 

分 类 号：R241.3[医药卫生—中医诊断学] R365[医药卫生—中医临床基础]