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作 者:曾杰[1] 陈宁波[1] 张健[1] 李艳[1] 陈仿[1] 刘建[1] 胡卫建[1]
机构地区:[1]四川省医学科学院.四川省人民医院急救中心外科,四川成都610072
出 处:《四川医学》2013年第3期289-292,共4页Sichuan Medical Journal
基 金:2009年四川省卫生厅科研课题(编号:090484)
摘 要:目的探讨血清炎性因子IL-6、IL-8、IL-10、TNF-α在多发伤中的作用,及对严重多发伤继发多器官功能不全综合征(MODS)的预测意义。方法选取我院急诊外科2009~2012年就诊的严重多发伤患者40例(多发伤组),分为MODS组(8例)和非MODS组(32例)。分别于发病就诊后第0、5、1、2、3、5、7天静脉取血,测定IL-6、IL-8、IL-10、TNF-α的含量,并与40例健康体检者(对照组)对照。结果多发伤患者组IL-6、IL-8、IL-10、TNF-α的含量在每个时段与对照组相比,差异均有统计学意义(P<0.05)。多发伤患者IL-6、IL-8、IL-10、TNF-α的含量在伤后即升高,第1~3天达峰值后开始下降,下降后仍明显高于正常对照组;MODS组TNF-α、IL-6、IL-8的含量在就诊后前3天均明显高于非MODS组(P<0.01),MODS组IL-10的含量在就诊后2~5天均明显高于非MODS组(P<0.01)。结论严重多发伤后能引起明显的细胞因子反应,伤后动态观察患者血清细胞因子IL-6、IL-8、IL-10、TNF-α水平的变化,有助于病情的评估及预后的判断。Objective To research the contributions of IL-6,IL-8,IL-10 and TNF-α for multiple injuries and the values for prediction of MODS that followed multiple injuries. Methods 40 patients in severe multiple injuries group which was divided into MODS group (8) and non-MODS group (32) ,which were treated in our emergency center from 2009 to 2012. The level of IL-6 ,IL-8 ,IL-10 and TNF-α in veno-blood serum were detected when the 0. 5,1,2,3,5,7 days after trauma, meanwhile 40 health examination patients were in control group. Results The levels of IL-6 ,IL-8 ,IL-10 and TNF-α were significant higher than con- trol group in each time point(P 〈 0. 05 ). The level of these cytokines increased immediately after trauma, and the peak value was achieved at 1 -3days; the level of TNF-α,IL-6 and IL-8 in MODS group were significant higher than non-MODS group in the first 3 days after trauma( P 〈 0.01 ), the level of IL-IO in MODS group was significant higher than non-MODS group in the 2 ,d - 5 .h day after trauma(P 〈0. 01 ). Conclusion The cytokines were active after trauma. The development observation for the level of IL-6 ,IL-8, IL -10 and TNF-α was benefit to evaluate the prognostic of severe multiple injuries.
关 键 词:多发伤 多器官功能不全综合征 免疫失衡 细胞因子
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