甲泼尼龙对急性肺损伤后血清IL-6、IL-8和TNF-α水平的影响及临床意义  

The clinical effect of methylprednisolone on serum IL-6,IL-8 and TNF-α after acute lung injury

作　　者：杨仁荣[1] 曹金林[1] 刘桂宝[1] 郑海燕[1] 陶进新[1] 史智杰[1] 施建国[1] 

机构地区：[1]解放军117医院胸外科,浙江杭州310004

出　　处：《东南国防医药》2013年第4期338-339,348,共3页Military Medical Journal of Southeast China

基　　金：全军医药卫生科研攻关基金课题(08G097)

摘　　要：目的探讨甲泼尼龙对急性肺损伤后血清IL-6、IL-8和TNF-α水平的影响及临床意义。方法对2010年1月-2012年11月收治的伤后2h内入院的急性肺损伤25例,抽取伤后2 h、4 h、8 h、12 h、24 h、48 h、72 h血液,对血清IL-6、IL-8和TNF-α水平进行检测,16例经早期、小剂量、短期内应用甲泼尼龙治疗[入院即开始予以静脉滴注甲泼尼龙2 mg/(kg.d),3 d后再逐渐减量至伤后7 d停用,激素组],9例未应用甲泼尼龙及其他激素类药物治疗(对照组),检测比较各水平的变化。结果 IL-6、IL-8在肺损伤后48 h达高峰,TNF-α在肺损伤后24 h达高峰,激素组上述各炎症指标在肺损伤12 h开始显著低于对照组(P<0.05)。结论急性肺损伤与血清IL-6、IL-8和TNF-α有关,早期、小剂量、短期内应用甲泼尼龙有助于减少炎性递质释放,改善因炎症性反应而引起的肺换气功能障碍,防止肺进一步损伤,有利于患者早日康复。Objective To investigate the clinical effect of methylprednisolone on serum IL-6,IL-8 and TNF-α after acute lung injury.Methods From January 2010 to November 2012,25 patients were admitted to our hospital within 2 hours after acute lung injury,whose blood was extracted in 2 h,6 h,12 h,24 h,48 h,72 h after trauma,serum IL-6,IL-8 and TNF-α were detected by enzymelinked immunosorbent assay（ELISA）.Early,low-dose and short-term therapy was applied with methylprednisolone in 16 cases（we began to infusion methylprednisolone of 2 mg /（kg.d） by intravenous after admission,3 days later,the dose of methylprednisolone gradually reduced until 7 days,hormone group）,and another nine cases,methylprednisolone and other hormonal drugs werent applied（control group）.The change of serum IL-6,IL-8 and TNF-α were compared.Results IL-6,IL-8 reached the peak at 48 hours after lung injury,but TNF-α reached a peak at 24 hours.The inflammatory cytokines in hormone group were extraordinary lower than control group after 12 h in lung injury（P ＆lt; 0.05）.Conclusion Acute lung injury has a relation with serum IL-6,IL-8 and TNF-α.Early,low-dose and short-term application of methylprednisolone will help to reduce the inflammatory mediators release,improve the lung ventilation dysfunction which caused by inflammatory reaction,prevent the further damage of lung,and conducive to patient recovery.

关 键 词：炎症因子 糖皮质激素 肺损伤 急救 

分 类 号：R563.1[医药卫生—呼吸系统]