探讨肿瘤坏死因子、白细胞介素-6、血小板活化因子与重症胸腹损伤后凝血功能障碍发生的关系  

Research on the correlation between tumor necrosis factor-α, interleukin-6 and platelet activating factor with coaguiopathy after severe chestabdomminal injury

作　　者：李志伟[1] 王著军 徐旭[2] 郭雅琼[1] 乔帅[1] 梁永刚[1] 李慧娟[1] 郭利民[1] 边慧娟[1] 蔡晶晶[1] 瑞霞[1] 

机构地区：[1]解放军第253医院急诊科,呼和浩特010051 [2]呼和浩特机场集团公司急救中心

出　　处：《临床急诊杂志》2013年第8期363-365,共3页Journal of Clinical Emergency

摘　　要：目的:探讨肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)和血小板活化因子(PAF)与胸腹重症创伤后凝血功能紊乱发生的相关性与其作用。方法:收集2009-01-2011-12在我院就诊的62例胸腹联合重症创伤患者,对创伤指数≥17分的患者,在就诊同时抽血检查血小板计数(PLT)、血浆D-二聚体(D-D)、部分活化凝血酶原时间(APPT)、凝血酶原时间(PT)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、血小板活化因子(PAF),对检验结果进行相关性检验。结果:监测结果相关性分析:D-D与TNF-α之间比较:r=-0.8590,P<0.01;D-D与IL-6之间比较:r=-0.8031,P<0.01;D-D与PAF之间比较:r=-0.8970,P<0.01。PT与TNF-α之间比较:r=0.8852,P<0.01;PT与IL-6之间比较:r=0.8612,P<0.01;PT与PAF之间比较:r=0.9054,P<0.01。TNF-α与IL-6之间比较:r=0.9012,P<0.01;TNF-α与PAF之间比较:r=0.9137,P<0.01。IL-6与PAF之间比较:r=0.9162,P<0.01。结论:肿瘤坏死因子、白细胞介素-6、血小板活化因子均参与了重症胸腹创伤后凝血机制障碍的发生,肿瘤坏死因子可能通过白细胞介素-6促进血小板活化因子的释放与活化,进而导致血小板的激活、释放、聚集与大量消耗,导致血小板减少症的发生,针对肿瘤坏死因子、白细胞介素-6、血小板活化因子进行早期干预,有可能改善重症胸腹创伤患者的凝血功能障碍。Objective： To observe the correlation between tumor necrosis factor-α（TNF-α）, interleukin--6 （IL-6） ,platelet activating factor （PAF） and the blood clotting fuction disorder in severe chest abdominal injury. Method： 62 subjects with severe chest abdominal injury were collected in the 253rd Hospital of PLA from January in 2009 to December in 2011. The trauma index were all above or equal to 17 points. All of the patients were exam- ined platelet count （PLT）,D--dimer （D--D）,activated partial thromboplastin time （APTT）,prothrombin （PT）, TNF-α,IL-6 and PAF for correlation analysis. Result：The correlation coefficients between D--D and TNF-α was --0. 8590（P〈0. 01） ,between D--D and IL 6 was --0. 8031（P〈0. 01） ,between D--D and PAF was --0. 8970（P 〈0.01）. The ones between PT and TNF-α was 0. 8852（P〈0.01）,between PT and IL-6 was 0. 8612（P〈0.01）, between PT and PAF was 0. 9054（P〈0.01）. The ones between TNF-α and IL 6 was 0. 9012（P〈0.01） ,between TNF-α and PAF was 0. 9137（P〈0.01 ）, between IL-6 and PAF was 0. 9162 （P〈0.01）. Conclusion： TNF-α, II76 and PAF all participate in the process of the blood clotting disorder in severe chest abdominal injury. It is possible that by means of IL-6 promoting the releasing and activation of PAF,TNF-α cause the activation and releasing and accumulation and consumption of blood platelets and then the occrrence of thrombopenia. The prophase interfer- ence in TNF-α, IL-6 and PAF is possible to improve the coagulation dysfunction in severe chest abdominal injury.

关 键 词：重症胸腹损伤 凝血功能紊乱 肿瘤坏死因子 白细胞介素-6 血小板活化因子 

分 类 号：R656[医药卫生—外科学]