血清肿瘤坏死因子样凋亡微弱诱导剂在脓毒症患者中的表达及临床意义  

Expression and clinical significance of serum tumor necrosis factor-like weak inducer of apoptosis in patients with sepsis

作　　者：沈述威[1] 王力甚[1] 

机构地区：[1]华中科技大学同济医学院附属荆州医院,湖北荆州434020

出　　处：《现代中西医结合杂志》2013年第36期3994-3995,3999,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨肿瘤坏死因子样凋亡微弱诱导剂(TWEAK)在脓毒症患者血清中的表达状况及临床意义。方法将45例非感染性全身炎症反应综合征(SIRS)者及56例脓毒症患者纳入研究。根据临床资料将脓毒症患者分为SIRS组(n=39)、脓毒症组(n=21)、严重脓毒症组(n=31)与脓毒性休克组(n=20);根据感染因素不同分为细菌感染、真菌感染与混合感染。所有患者血清TWEAK、肿瘤坏死因子(TNF-α)、白细胞介素6(IL-6)、C反应蛋白(CRP)被检测及记录。结果感染患者血清TWEAK水平明显高于非感染性SIRS患者(P<0.01);随着脓毒症表现越重,血清TWEAK水平越高,血清TNF-α有相似变化趋势(P<0.05),而血清IL-6及CRP在各组间无显著性差异(P>0.05);TWEAK水平在细菌、真菌或混合细菌真菌感染的3组间无显著性差异。结论脓毒症患者有高水平的TWEAK,脓毒症表现越重,血清TWEAK水平越高;TWEAK与感染的病原菌无关;TWEAK可以作为脓毒症患者的重要预测指标。Objective It is to approach the expression and clinical significance of serum tumor necrosis factor-like weak inducer of apoptosis （TWEAK） in patients with sepsis. Methods 45 non-infectious patients with systemic inflammatory re- sponse syndrome patients （SIRS） and 56 patients with sepsis were enrolled in this study. All patients were divided into 4 groups ： SIRS group （ n = 39） , sepsis group （ n = 21 ） , severe sepsis group （ n = 31 ） and septic shock group （ n = 20） ; they were also divided into 3 groups： bacterial infections group （ n = 31 ） , fungal infections group （ n = 31 ） and mixed infections group （n = 31 ） , according to the infection factors. The levels of serum TWEAK, TNF -a, IL -6, CRP were measured. Re- suits The serum levels of TWEAK were higher in patients with infection than that of non-infectious （ P 〈 0.01 ）. With the more severe sepsis performance, the levels of serum TWEAK were higher, so as the serum TNF - a levels （ P 〈 0.05 ）. There was no significant difference in serum IL - 6, CRP levels among all groups （ P 〉 0.05 ）. There was no significant difference in TWEAK levels among the bacterial infections group, fungal infections group and mixed infections group （P 〉 0. Ol ）. Conclu sion Serum TWEAK levels in patients with sepsis are markedly increased; with the more severe sepsis performance, the levels of serum TWEAK were higher. There is no relationship bentween serum TWEAK levels and pathogens. TWEAK may be an important predictor of sepsis.

关 键 词：脓毒症 肿瘤坏死因子样凋亡微弱诱导剂 炎症 

分 类 号：R364.5[医药卫生—病理学]