严重烧伤脓毒症患者血清TNF-α、IL-6、IL-10、PLA2的变化及器官功能损害状况分析  

The plasma levels change of TNF-α,IL-6,IL-10,PLA2 and organ lesion analysis of sever burn injury patients with sepsis

作　　者：陈凯[1] 

机构地区：[1]重庆医科大学附属永川医院烧伤整形外科,402160

出　　处：《重庆医学》2014年第8期937-940,共4页Chongqing medicine

摘　　要：目的研究严重烧伤脓毒症患者血清肿瘤坏死因子-α(TNF-α)、IL-6、IL-10、血清磷脂酶A2(PLA2)的变化及器官功能损害状况。方法该院自2010年3月至2011年3月共收治重度烧伤患者57例,33例发生脓毒血症,其中19例并发多器官功障碍综合征(MODS)。将其按照并发症状况分为脓毒血症组(S组)、脓毒血并发MODS组(M组)及阴性组(N组),对比3组患者的基本情况,IL-10、IL-6、TNF-α、PLA2等炎性相关介质浓度差异及变化趋势,器官功能障碍发病状况等。结果 S组和M组患者的PLA2、TNF-α、IL-6值明显高于N组,且治疗后无明显下降;3组患者血清IL-10变化趋势差异无统计学意义(P>0.05)。并发脓毒血症或MODS烧伤患者的烧伤面积较大、深度较深,器官衰竭及病死率显著高于一般烧伤患者,并以呼吸循环功能衰竭最为常见。结论严重烧伤患者的血浆PLA2、TNF-α、IL-6水平与烧伤程度呈正相关,其活性持续维持在高水平可能与患者发生脓毒血症及MODS密切相关,影响患者愈后。Objective To study plasma levels of tumor necrosis factor-α（TNF-α） ,IL-6 ,IL-10 ,serum phospholipase A2（PLA2） and organ lesion of sever burn injury patients .Methods 57 sever burn injury patients got treated in our department from March 2010 to March 2011 ,in which 33 of them had been diagnosed with sepsis and 19 of which developed into multiple organ dysfunction syndrome（MODS） ,the levels of IL-6 ,IL-10 ,TNF-α,PLA2 were compared among sepsis group（group N） ,MODS group（group M） and negative group（group N） .The organ disfunction and fatality rate were also analyzed .Results The PLA2 ,TNF-α,IL-6 levels of patients in group S and M were significantly higher than group N ,and showed no apparent decline during the first 14 day ;the change trend of IL-10 had no statistically significant difference among the 3 groups（P＆lt;0 .05） .The group S and M showed larger burned area and deeper burned depth ,the organ failure and mortality rate were significantly higher than group N ,And with the most common respiratory function failure .Conclusion The PLA2 ,TNF-α,IL-6 levels in sever burn injury patients might be closely relat-ed to the degree of burn .High plasma level of PLA2 ,TNF-α and IL-6 might be closely associated with occurrence of sepsis and MODS and their outcome .

关 键 词：烧伤 多器官功能障碍 肿瘤坏死因子α 白细胞介素类 磷脂酶A2 PHOSPHOLIPASE A2 

分 类 号：R459.7[医药卫生—急诊医学]