严重肺挫伤患者冯·维勒布兰德因子，白介素8的动态变化及其意义  

The expression of yon Willebrand factor and interleukin-8 in severe pulmonary contusion patients

作　　者：钱进先[1] 陆骏灏[3] 陆士奇[1] 赵益明[2] 

机构地区：[1]苏州大学附属第一医院急诊科,江苏省苏州215006 [2]苏州大学附属第一医院血液研究所,江苏省苏州215006 [3]南通大学附属吴江医院

出　　处：《中华急诊医学杂志》2011年第6期583-587,共5页Chinese Journal of Emergency Medicine

摘　　要：目的通过检测严重肺挫伤患者血中冯·维勒布兰德因子（vwF），白介素8在受伤后不同时点的含量，揭示其动态变化规律及其临床价值。方法将63例严重肺挫伤患者分成ARDS组和非ARDS组、生存组和死亡组、ISS评分〈20分和ISS评分≥20分组，并引入正常对照组，使用ELISA法分别检测伤后24h内、第3天、第5天、第7天时的血浆vwF和血清IL．8水平，观察其动态规律，并进行相关因素分析。结果严重肺挫伤患者在各时点，血浆vWF和血清IL-8均高于正常对照组。严重肺挫伤并发ARDS组血浆vWF含量各时点逐渐升高，ARDS组在第5天、第7天血浆vwF含量显著高于非ARDS组（P〈0．05），血清IL-8含量在第5天达到高峰后开始下降，两组之间在各时点差异具有统计学意义（P〈0．05）；死亡组血浆vwF与血清IL-8含量均显著高于生存组（P〈0．05）；ISS评分／〉20分组血浆vWF和血清1L-8水平均在第5天达到高峰后开始回落，ISS评分〈20分组在第3天达到高峰后回落。血浆vWF含量与血小板计数呈正相关，与氧合指数呈负相关。血清IL-8含量与白细胞计数、ISS评分呈正相关，与氧合指数呈负相关。结论严重肺挫伤患者血中vWF和IL一8含量呈动态变化，反映了肺损伤的程度，并可以作为严重肺挫伤后并发ARDS的预测及预后判断指标。Objective To study the clinical changes of von Willebrand factor（vWF） and interleukin-8 （IL-8） in patients with severe pulmonary contusion. Methods Sixty-three patients with severe pulmonary contusion were divided into three different classifications for the sake of comparison in different respects, namely （1） severe pulmonary contusion with ARDS group and severe puhnonary contusion without ARDS group, （2） survival group and non-survival group, and （3） ISS score 〈20 group and ISS score≥20 group. In addition, the normal control group was set up. The levels of plasma vWF and serum 1L-8 were respectively detected by double-antibody sandwich enzyme-linked immunosorbent assay （ELISA） within 24 hours of injury and 1, 3, 5 and 7days after injury. The regularity of their changes was observed and the correlation factors were analyzed from the data. Results Compared with normal controls, the concentrations of plasma vWF and serum IL-8 were significantly increased in patients with severe puhnonary contusion in all intervals of detection. The concentrations of plasma vWF escalated gradually in severe pulmonary contusion with ARDS, and reached significantly higher levels in 5 days and 7 days after injury compared with those without ARDS group （P 〈 0.05 ）. The increase in concentrations of serum IL-8 peaked in 5day after injury, and then declined. The levels of serum IL-8 were higher in patients with severe pulmonary contusion with ARDS group than those in this kind of patients without ARDS group. The levels of plasma vWF and serum IL-8 were higher in non-survival group than those in survival group（ P 〈 0.05 ）. The increase in levels of plasma vWF and serum IL-8 peaked and then declined in 5 days in ISS score ≥20 group, whereas it peaked and declined in 3 days after injury in ISS score 〈 20 group. The level of plasma vWF was positively correlated with platelets and negatively correlated with oxygenation index. The levels of serum IL-8 was positively correlated with white blood cell c

关 键 词：创伤 肺挫伤 血管性假血友病因子 呼吸窘迫综合征 白细胞介素 

分 类 号：R655.3[医药卫生—外科学]