多发伤合并肺部感染患者血清及痰液细胞因子的变化观察  

Changes of serum and sputum cytokines in multiple trauma patients complicated with pulmonary infections

作　　者：张荣[1] 刘咏芳[2] 汤鲁明[1] 林露阳[1] 陈大庆[1] 王伟[1] 孙震宇[1] 张杨阳[1] 项洪武[1] 

机构地区：[1]温州医科大学附属第二医院急诊科,浙江温州325027 [2]温州医科大学附属第二医院超声影像科,浙江温州325027

出　　处：《中华医院感染学杂志》2017年第2期348-350,421,共4页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金项目(LY14H150010)

摘　　要：目的观察多发伤合并肺部感染患者血清及痰液细胞因子的变化情况,为多发伤患者肺部感染的诊断与控制提供依据。方法选取2013年6月-2016年6月医院EICU、急诊创伤病房、急诊留观病房进行治疗的46例多发伤合并肺部感染患者为A组,同时期的46例多发伤患者为B组,46名健康人员为C组,然后将三组研究对象的血清及痰液细胞因子进行检测及比较,并比较A组不同肺部感染程度患者的血清及痰液细胞因子水平。结果 A组血清及痰液细胞因子IL-4、IL-8、IL-16、TNF-α、IFN-γ水平分别为(2.46±0.19)ng/ml、(11.98±1.41)pg/ml、(45.29±4.33)ng/L、(2.37±0.26)ng/ml、(71.89±6.02)pg/ml及(3.36±0.29)ng/ml、(14.65±1.79)pg/ml、(51.80±4.62)ng/L、(3.31±0.40)ng/ml、(79.96±6.93)pg/ml,均高于B组及C组的检测水平,B组的检测水平则高于C组,且A组肺部感染较重者的检测水平高于感染较轻者,差异均有统计学意义(P<0.05)。结论多发伤合并肺部感染患者血清及痰液细胞因子呈现高表达状态,且肺部感染程度对其表达水平的影响较大。OBJECTIVE To observe the changes of serum and sputum cytokines in multiple trauma patients complicated with pulmonary infections so as to provide guidance for diagnosis and control of the multiple trauma patients complicated with pulmonary infections. METHODS A total of 46 multiple trauma patients complicated with pulmonary infection who were treated in EICU, emergency trauma wards, and emergency observation wards from Jun 2013 to Jun 2016 were chosen as the group A, meanwhile, 46 multiple trauma patients were set as the group B, and 46 healthy people were chosen as the group C. The serum and sputum cytokines were detected and compared among the three groups of study objects, and the levels of serum and sputum cytokines among the patients with different degree of pulmonary infection in the group A. RESULTS The levels of serum cytokines IL-4, IL-8, IL-16, TNF-α, and IFN-γ of the group A were respectively （2. 46±0. 19）ng/ml, （11.98±1.41）pg/ml, （45.29±4.33） ng/L, （2.37±0.26）ng/ml, and （71.89=k6.02）pg/ml, higher than those of the group B and group C; the levels of sputum cytokines IL-4, IL-8, IL-16, TNF-α, and IFN-γ of the group A were respectively （3.36±0.29）ng/ml, （14.65±1.79）pg/ml, （51.80±4.62）ng/L, （3.31±0.40）ng/ml, and （79.96±6.93）pg/ml, higher than those of the group B and group C; the levels of the above cytokines of the group B were higher than those of the group C, and the levels of the above cytokines of the patients with severe pulmonary infection were higher than those of the patients with mild infection, and there was significant difference （P〈0.05）. CONCLUSION The serum and sputum cytokines show high-expression state in the multiple trauma patients complicated with pulmonary infec tion, and the degree of pulmonary infection has great impact on the expression level.

关 键 词：多发伤 肺部感染 血清 痰液 细胞因子 

分 类 号：R563.1[医药卫生—呼吸系统]