重症感染患者应激激素和细胞因子与能量消耗的关系  

Relationship between stress hormone,cytokines and energy expenditure in septic patients

作　　者：张斌[1] 黎介寿[1] 全竹富[1] 汪义军[1] 

机构地区：[1]南京军区南京总医院全军普外研究所

出　　处：《中国危重病急救医学》1999年第12期750-752,共3页Chinese Critical Care Medicine

基　　金：南京军区南京总医院博士研究生课题基金

摘　　要：目的：确立能反映能量代谢应激程度的有效指标，为营养支持时的能量补充量提供参考依据。方法：同步测定重症感染患者静息能量消耗（ＲＥＥ）、应激激素、细胞因子〔包括肿瘤坏死因子（ＴＮＦ）、白介素 ６（ＩＬ６）〕水平，并作疾病严重度评分（ＡＰＡＣＨＥⅡ）和感染严重度评分（ＳＳＳ）。将患者分为高代谢（ＲＥＥ／ＨＢ≥１１０％ ）及正常代谢（ＲＥＥ／ＨＢ＜ １１０％ ）２组，分析各指标与能量消耗变化的相关程度。结果：虽然感染组患者的ＴＮＦ、ＩＬ ６、糖皮质激素和Ｃ 反应蛋白（ＣＲＰ）水平及ＡＰＡＣＨＥⅡ、ＳＳＳ评分均明显高于对照组（Ｐ均＜ ０．０５），但只有ＩＬ ６、糖皮质激素和ＣＲＰ与能量消耗间存在密切关系（Ｐ＜ ０．０５）。结论：疾病种类及严重度评分不能判断患者是否存在能量代谢的应激，ＣＲＰ、ＩＬ ６Objective:To select some effective parameters that can reflect the degree of energy metabolic stress,and to evaluate their roles in predicting the amount of energy supplement.Methods:Levels of stress hormone (glucocorticoid),cytokinse and the APACHE Ⅱ,SSS scores were assessed,while the resting energy expenditure (REE) was measured in 10 septic patients.The relationship between these parameters and the degree of energy metabolism was analyzed,with the patients assigned into high metabolic and normal metabolic groups.Results:Although the levels of tumor necrosis factor (TNF),interleukin6(IL6),glucocorticoid, Creactive protein (CRP),and the scores of APACHE Ⅱ,SSS were higher in septic patients (all P <0 05),only CRP,IL6 and glucocorticoid had significant relations with energy expenditure ( P <0 05).Conclusions:The disease itself and severity of the disease can not be used to judge if the energy stress exists,while CRP,IL6 and glucocorticoid are dependable parameters to predict the change in energy expenditure of septic patients.

关 键 词：重症感染 能量消耗 细胞因子 应激激素 

分 类 号：R631[医药卫生—外科学]