颅脑损伤患者血清可溶性白细胞介素-2受体和肿瘤坏死因子-α的变化  

Changes of Soluble Interleukin-2 Receptors and Tumor Necrosis Factor- in Patients with Severe Head Injury

作　　者：殷光中[1,2] 管惟苓[1,2] 蒋文旭[1,2] 车志豪 杜彦李[1,2] 

机构地区：[1]苏州市第四人民医院神经外科 [2]苏州市第二人民医院神经外科

出　　处：《中华创伤杂志》1999年第3期200-202,共3页Chinese Journal of Trauma

摘　　要：目的研究颅脑损伤患者可溶性白细胞介素－２受体和肿瘤坏死因子－α在创伤感染发生机制中的作用。方法本组５３例分为ＧＣＳ＞８分组（２５例）和ＧＣＳ≤８分组（２８例）及创伤组（３３例）和创伤感染组（２０例）。于入院后第１，３，７和１４天抽取血样，运用双抗体夹心ＥＬＩＳＡ法测定ｓＩＬ－２Ｒ和ＴＮＦ－α含量。结果（１）ＧＣＳ≤８分组伤后第１天ｓＩＬ－２Ｒ及ＴＮＦ－α水平皆高于ＧＣＳ＞８分组和正常对照组；（２）创伤感染组ｓＩＬ－２Ｒ水平持续升高，３～７天最为显著，伤后１４天仍未降至正常水平，而创伤组无此改变；（３）创伤组和创伤感染组均见ＴＮＦ－α短暂升高。结论重型颅脑损伤后，ｓＩＬ－２Ｒ在细胞免疫功能紊乱及创伤感染的发生机制中起重要作用，而ＴＮＦ－α参与了早期病理过程。Objective To evaluate the role of soluble interleukin-2 receptors (sIL-2R) and tumor necrosis factor- (TNF-) in the mechanism of traumatic infection. Methods Fifty-three head injured patients were divided into a GCS>8 group (n=25) and a GCS8 group (n=28); a noninfection group (n=33) and an infection group (n=20) during their stay in hospital. The serum sIL-2R and TNF- were measured by enzyme-linked immunosorbent assay (ELISA) technique on the 1st, 3rd , 7th and 14th posttrauma days. Results Levels of sIL-2R and TNF- increased significantly in patients with head injury on the day of admission in GCS8 group compared with that in GCS>8 group and normal controls. A persistent elevation of sIL-2R was found in patients in infection group on days 1 through 14, peaking from the 3rd day to the 7th day, but no change in the noninfectious group. A temporary elevation of TNF- level was seen in both noninfection and infection groups. Conclusions sIL-2R plays an important role in the mechanism of posttraumatic cellular immunological disturbances and infection in head-injured patients. TNF- may be involved only in the early pathogenesis.

关 键 词：颅脑损伤 白细胞介素2 SIL-2R 肿瘤坏死因子 

分 类 号：R651.15[医药卫生—外科学]