脓毒性休克患者肿瘤坏死因子-α 白细胞介素-10与血清降钙素原动态变化相关关系研究  

The correlation research for dynatnic changes inflammatory eytokines for septic shock patients

作　　者：苏明华[1] 杨鹏[1] 宋孟龙[1] 章晓红[1] Su Ming-hua;Yang Peng;Song Meng-long;Zhang Xiao-hong(Sichuan Academy of Medical Sciences ＆ Sichuan Provincial People＇s Hospital,Chengdu 610072)

机构地区：[1]四川省医学科学院四川省人民医院,四川成都610072

出　　处：《中国急救医学》2018年第9期757-760,共4页Chinese Journal of Critical Care Medicine

基　　金：四川省卫生厅科研课题（090489）

摘　　要：目的 监测脓毒性休克患者肿瘤坏死因子-α（TNF-α）、白细胞介素-10（IL-10）与降钙素原（PCT）动态变化相关关系及其临床价值。方法 2014-01～2016-01我院EICU收治的60例脓毒性休克患者作为研究对象，按预后分为存活组和死亡组，动态监测入院第1、3、5、7天PCT、TNF-α、IL-10，PCT采用免疫化学发光法检测，TNF-α、IL-10采用双抗体夹心酶联免疫分析法（ELISA法）进行测定。结果 存活组与死亡组TNF-α均于第3天达到峰值水平，之后逐渐下降，存活组第1、3、5、7天TNF-α值（ng/L）为108.2±29.3、 126.1±32.2、85.9±23.4、47.7±13.2，死亡组为135.1±36.3、 162.2±41.9、126.7±34.5、88.1±31.6，相同时间点组间比较P值分别为0.011、0.005、0.006、0.004，均为死亡组显著高于存活组；两组IL-10均逐渐升高，第5天达到峰值水平，之后存活组第7天显著下降，而死亡组仍维持高水平，存活组第1、3、5、7天IL-10值（ng/L）42.1±13.5、53.9±17.1、69.8±17.7、38.2±13.1，死亡组为53.4±15.8、79.2±26.5、109.3±31.4、107.7±25.9，相同时间点组间比较P值分别为0.008、0.004、〈0.001、〈0.001，均为死亡组显著高于存活组，其中存活组第5、7天比较P值 0.003，死亡组第5、7天比较P值 0.36。存活组第1、3、5、7天PCT值（μg/L）6.3±2.7、15.5±9.1、4.6±2.9、1.5±0.9，第3天达到峰值水平，之后逐渐下降，相邻监测时间点两两比较差异有统计学意义（P〈0.05）；死亡组第1、3、5、7天PCT值（μg/L）11.8±5.6、43.5±17.9、42.7±19.8、45.1±18.2，第3、5、7天持续维持高水平，相邻两时间点两两比较，P值分别为0.16、0.22，差异无统计学意义（P＞0.05），存活组与死亡组第1、3、5、7天相同时间点PCT比较，P均〈0.001，死亡组均显著高于存活组，差异有统计学意义（P〈0.01）。存活组TNF-α、IL-10Objective To research the relationship between blood procalcitonin and Pro -and anti - inflammatory eytokines for septic shock patients in ICU, which those monitored with TNF - α, IL -10 and PCT, and assess the significance for Clinical condition. Methods From January 2014 to January 2016,60 septic shock patients which were received in EICU were divided into the survival group and the death group. Measure target：the first, third, fifth, seventh day morning, Serum of 60 patients were collected, PCT was detected by immunochemiluminescence, TNF -α and IL - 10 were measured by double antibody sandwich enzyme immunoassay （ELISA）. Results Both of the two groups TNF - α were rised in early phase, and the third day reached the peak level, then gradual declined, the value of TNF - α（ng/L） on the first, third, fifth and 7 days of the surviVal group was 108.2 ± 29.3,126.1 ± 32.2,85.9 ± 23.4,47.7 ± 13.2, and the death group was 135.1 ± 36.3,162.2± 41.9,126.7±34.5, 88.1±31.6, at the same time point, P values were 0. 011, 0. 005, 0. 006 and 0. 004, respectively, which were significantly higher in the death group than in the survival group. In both groups, IL - 10 gradually increased and reached the peak level on the fifth day, then decreased significantly on the seventh day after survival, while the death group remained at a high level. The IL - 10 value of the first, third, fifth and 7th days in the survival group （ng/L） was 42.1 ±13.5,53.9 ±17.1,69.8 ± 17.7,38.2 ± 13.1, and the death group was 53.4 ± 15.8, 79.2±26.5,109.3 ± 31.4,107.7± 25.9, the P values were 0. 008, 0. 004, 〈 0. 001 and 〈 0. 001, which were all significantly higher in the death group than in the survival group, of which the survival group was compared with fifth, seventh days, the P value was 0.003, the death group was fifth, seventh days, and the P value was 0.36. The PCT value of first, third, fifth and seventh days in the survival group （μg/L） was 6.3 ± 2.7,15.5± 9.1,4.6 ± 2.9,1.5±0.9. The death group was 11

关 键 词：脓毒性休克 炎症因子 降钙素原(PCT) 多器官功能障碍综合征(MODS) 

分 类 号：R587.1[医药卫生—内分泌]