急性肺血栓栓塞症溶栓后炎症因子的变化  

Changes of inflammatory factors after thrombolytic therapy in acute pulmonary thromboembolism

作　　者：段亚敏[1] 崔慧敏[1] 赵树霞[2] 郝俊生[1] 李运启 

机构地区：[1]河北省保定市骨科医院,河北保定071000 [2]河北省保定市第一中心医院,河北保定071000

出　　处：《现代中西医结合杂志》2015年第20期2191-2193,2196,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨急性肺血栓栓塞症(APTE)转归中炎症因子的变化规律,寻找反映APTE患者肺损伤程度的敏感指标和溶栓预后的预测指标。方法选择APTE患者60例作为APTE组,同期健康体检者60例作为对照组。检测2组溶栓前及溶栓后不同时间段血浆超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、IL-6、IL-10水平。结果 APTE组溶栓前血浆hs-CRP、TNF-α、IL-1β、IL-6及IL-10水平均明显高于对照组(P均<0.01)。hs-CRP水平溶栓后各时间点呈逐渐下降趋势;TNF-α水平在溶栓后即刻明显增高,之后呈逐渐下降趋势;IL-1β、IL-6水平在溶栓后即刻、溶栓后2 h无明显变化,溶栓后6 h明显下降,溶栓后24 h明显低于溶栓前(P<0.01)。IL-10水平在溶栓前后均保持较高水平。结论 APTE的发生与多种炎症递质有关,TNF-α为预测APTE肺损伤最敏感的因子,IL-1β、IL-6联合hs-CRP可用于监测APTE的发生及溶栓效果,IL-10可起到缓解肺损伤、协助组织修复的作用。Objective It is to explore the change regulation of inflammatory factors in development of acute pulmonary thromboembolism（ APTE）,thus to fine out a more sensible standard to indicate the injury degrees of lung in APTE patients and decide a prediction standard of thrombolytic therapy prognosis. Methods 60 cases of patients with APTE were selected as APTE group,60 healthy person accepted body examination as control group. The levels of plasma hs- CRP,TNF- α,IL-1β,IL- 6 and IL- 10 were detected in the subjects of the control group and the patients in APTE group before thrombolytic therapy,at different time after thrombolytic therapy. Results The levels of hs- CRP,TNF- α,IL- 1β,IL- 6 and IL- 10 in APTE group before thrombolytic therapy were significantly higher than that in control group（ P 〈0. 01）. Specifically,after thrombolytic therapy,there were some concrete characters of each item： the density level of hs- CRP went down as time went by; TNF- α arised immediately and carried a trend of decline; while IL- 1β and IL- 6 showed nothing apparent changes during the first 2 hours,they began to decline in the next 4 hours and still sustained a high level at 24 hours; IL- 10 still stayed in high level. Conclusion The occurrence of APTE is related with a variety of phlogistons,however,TNF- α is the most sensible factor to predict acute pulmonary thrombembolism. Combing IL- 1β,IL- 6 and hs- CRP,the occurrence of APTE and effect of thrombolytic therapy can be monitored precisely. Moreover,IL- 10 can release the symptom of acute pulmonary thrombembolism and play a positive role in assisting the recovery of tissues.

关 键 词：肺血栓栓塞症 肿瘤坏死因子-Α 白细胞介素-1Β 白细胞介素-6 

分 类 号：R563.5[医药卫生—呼吸系统]