急性有机磷中毒患者早期血清中白细胞介素l0和肿瘤坏死因子α的表达  

Expression of early-stage serum IL-IO and TNF-α in patients with acute organophosphorus pesticide poisoning

作　　者：吴孟章 欧阳荡玉 黄芳 熊光仲[2] 

机构地区：[1]岳阳市二人民医院急诊科,湖南414000 [2]中南大学湘雅二医院急诊科

出　　处：《中华急诊医学杂志》2011年第7期746-748,共3页Chinese Journal of Emergency Medicine

摘　　要：目的探讨急性有机磷中毒患者早期血清中白细胞介素（IL）-10和肿瘤坏死因子（TNF）-α的表达及意义。方法收集岳阳市二人民医院急诊科收治既往健康的急性有机磷农药中毒患者186例，按急性中毒诊断分级将186例患者分为轻度组、中度组和重度组。收集30例健康体检者作对照组。入院对患者进行APACHEⅡ评分，抽静脉血，用酶联免疫法测定血清中IL-10和TNF-α浓度。结果中毒患者随病情加重而APACHEⅡ评分升高，差异均具有统计学意义（P〈0．05）。中毒患者血清中IL-10浓度略高于对照组，差异无统计学意义（P〉0．05）。对照组、轻度组、中度组和重度组患者血清中TNF-α依次升高，组间比较差异均有统计学意义。IL-10与APACHEⅡ评分无相关性，TNF-α与APACHEⅡ评分呈正相关性，TNF-α／IL-10比值与APACHEⅡ评分呈高度正相关性（P〈0．01）。结论急性有机磷中毒患者机体同时存在促炎反应和抗炎反应，炎症促进因子过度释放及炎症促进因子与炎症抑制因子平衡失调与急性有机磷中毒病情程度有关，是急性有机磷中毒引发多器官功能障碍综合征的重要机制之一。Objective To investigate the expression and clinical significance of early-stage serum interieukin-10 （IL-10） and tumor necrosis factor-ct （TNF-α） in patients with acute organophosphorus pesticide poisoning （AOPP）. Method 186 cases of AOPP were divided into mild group, moderate group and severe group according to the severity. 30 healthy volunteers served as control group. APACHE Ⅱ scores were evaluated for these patiences and their serum concentrations of IL-10 and TNF-α were detected by enzyme-linked immunosorbent assay （ELISA）. Results APACHE II scores increased significantly with the exacerbations of AOPP （P 〈 0. 05）. The serum IL-10 concentrations of AOPP was slightly higher than the control group. There was no significant difference compared with the control group （ P 〉 0.05 ）. APACHE Ⅱ scores positively correlated with the serum TNF-α concentrations, but not with the serum IL-10. However, the ratio of TNF-α and IL-10 positively correlated with APACHE Ⅱ scores （ P 〈 0. 01 ）. Conclusions There were pro-inflammatory response and anti-inflammatory response in patients with AOPP. Overrelease of inflammation promoting factor and imbalance between inflammation promoting and inhibiting factors correlated with the severity of AOPP, which may be an important mechanism of multiple organ dysfunction syndrome of AOPP.

关 键 词：急性有机磷农药中毒 白细胞介素-10 肿瘤坏死因子-α 多器官功能障碍综合征 

分 类 号：R595.4[医药卫生—内科学]