百草枯中毒患者血清肿瘤坏死因子-α白细胞介素-6及百草枯浓度变化的分析  

Analysis of the changes of the serum concentration of TNF -α, IL - 6 and paraquat in the patients with paraquat poisoning

作　　者：李闯[1] 郝同琴[1] 刘建萍[2] 梁东良[1] 

机构地区：[1]新乡医学院第一附属医院急诊科,河南453100 [2]新乡医学院第三附属医院外一科,453003

出　　处：《中国急救医学》2010年第8期739-741,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的通过监测百草枯中毒患者血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）及百草枯浓度变化，从而探讨百草枯致机体多器官衰竭的发病机制。方法采用酶联免疫吸附法（ELISA）监测15例百草枯中毒患者在中毒4、24及96h后血清TNF-α、IL-6浓度；应用高效液相色谱法（HPLC）监测同期血清百草枯浓度，选取20例正常人作为对照。结果患者百草枯中毒4h后血清TNF-α及IL-6浓度即出现异常升高，随着时间延续，百草枯中毒后血清TNF-α及IL-6浓度水平持续进行性升高（P均〈0．01），TNF-α与IL-6之间存在高度相关性；血清百草枯浓度持续处于高浓度水平，各阶段血清百草枯浓度之间差异无统计学意义（P〉0．05），血清TNF-α及IL-6浓度持续进行性升高与百草枯浓度无明显相关性。结论中到重型百草枯患者血清TNF-α、IL-6浓度持续进行性升高，致机体出现全身炎症反应综合征（SIRS），终致多器官衰竭（MOF）。Objective To investigate the changes of serum concentration of tumor necrosis factor -α （ TNF -α）, interleukin - 6 （ IL - 6） and paraquat （ PQ ） in the patients with PQ poisoning and to explore the mechanisms of multiple organ failure （MOF） caused by PQ poisoning. Methods 15 patients with PQ poisoning were selected for this study. The enzyme linked immunosorbent assay （ELISA） was used for detecting the serum concentration of TNF-α and IL- 6, and the high performance liquid chromatography （HPLC） was used for detecting the serum concentration of PQ at 4, 24 and 96 h after admission. 20 normal individuals were served as controls. Results The serum concentration of TNF -α and IL - 6 in the patients with PQ poisoning were abnormal increase at 4 h after admission, and were progressively increased with the extension of time （ all P 〈 0. 01 ）, TNF -α and IL - 6 was significantly associated in the patients with PQ poisoning. The serum concentration of PQ was maintained in high level, there was no difference at the different points （P 〉 0. 05）. Both TNF -α and IL- 6 were not significantly associated with the serum concentration of PQ. Conclusion The high serum concentration of PQ induces progressive increase of serum concentration of TNF -α and IL - 6, and leads to systemic inflammatory response syndrome （SIRS）, then to MOF.

关 键 词：百草枯中毒 肿瘤坏死因子-α(TNF-α) 白细胞介素-6(IL-6) 多器官衰竭(MOF) 全身炎症反应综合征(SIRS) 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]