肿瘤坏死因子-α、内毒素、磷脂酶A_2与重症胸腹损伤急性肝损伤的相关性研究  

Correlation between Tumor Necrosis Factor-α( TNF-α),Lipopolysaccharide( LPS) and Phospholipase A_2( PLA_2 ) with Acute Liver Faction Disorders after Severe Chest-abdomen Injury

作　　者：李志伟[1] 王著军 徐旭[1] 郭雅琼[1] 乔帅[1] 梁永刚[1] 马之嘉[1] 高文华[1] 付芳[1] 瑞霞[1] 

机构地区：[1]中国人民解放军第253医院急诊科,呼和浩特010051 [2]呼和浩特国际机场集团有限公司急救中心,010070

出　　处：《医学研究杂志》2014年第1期100-102,共3页Journal of Medical Research

摘　　要：目的探讨肿瘤坏死因子-α（TNF—α）、内毒素（LPS）、磷脂酶A2（PLA2）在重症胸腹损伤急性肝损伤发生过程中的作用。方法收集2009年1月～2012年6月在解放军第253医院急诊科就诊，创伤指数（TI）≥17分、除外合并颅脑损伤及在急诊死亡的胸腹创伤患者82例，在就诊救治的同时抽血检查谷丙转氨酶（ALT）、谷草转氨酶（AST）、TNF-α、LPS和PLA2，对检验结果进行相关性分析。结果肝功能：ALT208．43±41．35U／L，AST198．49±39．62U／L；损伤因子：TNF—α 36．41±18．09ng／ml；LPS343．66±106．02IU／L；PLA，41．35±14．26ng／ml。ALT、AST与TNF—α、LPS、PLA，比较相关系数（r）分别大于0．8657、0．8860，均呈显著正相关。结论TNF—α、LPS、PLA，参与了重症胸腹损伤后急性肝损伤的发生、发展。急诊救治胸腹损伤时，应对TNF-α、LPS、PLA，进行早期干预，或有可能抑制急性肝损伤的发生或减轻损害的程度。Objective To investigate the correlation between tumor necrosis factor-α （TNF-α） ,lipopolysaccharide（LPS） ,phos- pholipase A2 （ PLA2 ） with acute liver faction disorders in severe chest - abdominal injury. Methods 82 subjects with severe chest - ab- dominal injury were collected in the 253th Hospital of PLA from January in 2009 to June in 2012 ,of whom the trauma index were all above or equal to 17 points. The patients were examined for alanine aminotransferas （ALT） , aspartate aminotransferase （AST） , TNF -α, LPS, PLA2 for correlation analysis. Results The liver function examined results were ALT 208.43 ±41.35U/L,AST 198.49 ± 39.62U/L. In- jury factors examined results were TNF - α 36.41 ± 18.09ng/ml,LPS 343.66 ± 106.02IU/L,PLA2 41.35 ± 14.26ng/ml. There was obvi- ously correlation between the liver function with injury factors. Conclusion TNF - α,LPS and PLA2 all participate in the process of the a- cute liver faction disorders in severe chest - abdominal injury. The prophase interference in TNF - α, LPS, PLA2 is possible to improve the liver function dysfunction in severe chest - abdominal injury.

关 键 词：重症胸腹创伤 急性肝损伤 肿瘤坏死因子 内毒素 磷脂酶A2 

分 类 号：R656[医药卫生—外科学]