患者血清中TNF-α、IL-6因子的水平与发生肺挫伤的关系  

The relationship between the levels of serum TNF-αand IL-6 and the occurrence of pulmonary contusion

作　　者：韩遵华 欧阳兴[1] 蒋亮[1] 段淼[1] HAN Zun-hua;OU Yang-xing;JIANG Lian(The First People's Hospital of Zunyi City,Zunyi 563002,China)

机构地区：[1]遵义市第一人民医院,贵州遵义563002

出　　处：《吉林医学》2020年第12期2866-2869,共4页Jilin Medical Journal

基　　金：贵州省遵义市科技局联合基金项目[项目编号:遵市科合社字(2017)39号]。

摘　　要：目的:研究胸部损伤患者血清中肿瘤坏死因子-a(TNF-α)、白细胞介素-6(IL-6)与发生肺挫伤的关系。方法:选择2016年7月~2017年7月在遵义市第一人民医院治疗的80例胸部损伤患者作为研究对象,分为肺挫伤组38例和未发生肺挫伤组42例,检测所有患者血清中TNF-α、IL-6以及监测血流动力学及氧动力学指标,探讨血清中TNF-α、IL-6与发生肺挫伤的关系。结果:肺挫伤组TNF-α、IL-6、肺动脉压(mPAP)明显高于未发生肺挫伤组,心排出血量(CO)、动脉血氧饱和度(SaO 2)、动脉血pH明显低于未发生肺挫伤组,差异均有统计学意义(P<0.05)。心排血指数(CI)、混合静脉血氧饱和度(SvO 2)、氧输送(DO 2)、氧消耗(VO 2)、右室做功指数(RVSWI)两组比较差异无统计学意义(P>0.05)。IL-6(AUC:0.84)、TNF-α(AUC:0.84)和mPAP(AUC:0.82)诊断价值较高。结论:肺挫伤患者血清中TNF-α、IL-6是患者发生肺挫伤的独立危险因素,诊断价值较高,值得临床重点关注。Objective To study the relationship between the levels of serum TNF-αand IL-6 in patients with pulmonary contusion.Method The June 2016-2017 in our hospital during the treatment of pulmonary contusion in 80 patients as the research object,divided into pulmonary contusion group 38 cases and non-pulmonary contusion group 40 cases,all patients were detected in blood serum TNF-α,IL-6 and monitoring hemodynamics and oxygen dynamics,to explore the relationship between serum TNF-α,IL-6 and pulmonary contusion.Results The three indicators of TNF-α,IL-6,and pulmonary arterial pressure(mPAP)were significantly higher in the lung contusion group than in the non-pulmonary contusion group,and cardiac output(CO),arterial oxygen saturation(SaO 2),and arterial blood pH.Compared with the two groups,the pulmonary contusion group was significantly lower than the non-pulmonary contusion group(P<0.05).Cardiac blood flow index(CI),mixed venous oxygen saturation(SvO 2),oxygen delivery(DO 2),oxygen consumption(VO 2),right ventricular work index(RVSWI)were not statistically different(P>0.05);IL-6(AUC:0.84),TNF-α(AUC:0.84)and mPAP(AUC:0.82)was an independent risk factor for pulmonary contusion.Conclusion Serum TNF-αand IL-6 are the independent risk factors of respiratory failure in patients with pulmonary contusion and higher diagnostic value,it is worthy of clinical attention.

关 键 词：肺挫伤 炎性因子 ROC曲线 

分 类 号：R563[医药卫生—呼吸系统]