摘要
目的 探讨内毒素对严重烧伤后细胞因子、可溶性粘附分子及sFas sFasL的影响。方法 选择烧伤总面积 (TBSA) >30 %患者 2 8例 ,健康志愿者 4 0例作为正常对照组。分别于伤后不同时相点 (伤后 1、 3、 5、 7、 14、 2 1、 2 8和 35d)测定患者血中内毒素、细胞因子 (TNF α、IL 1β、IL 6、IL 8、IL 12和IL 18)、可溶性粘附分子 (ICAM 1和VCAM 1)以及sFas sFasL的水平。按内毒素水平将其分为三组 :A组 ,脂多糖 (LPS)为 0～ 0 2 0 0U ml;B组 ,LPS为 0 2 0 0～ 0 4 0 0EU ml;C组 ,LPS >0 4 0 0EU ml。结果 与A组和正常对照组比较 ,B组和C组的TNF α、IL 1β、IL 6、IL 8、IL 18和ICAM 1水平在不同时相点均呈显著性上升 (P <0 0 5～ 0 0 1) ;而B组和C组患者血中VCAM 1和sFas sFasL水平在部分时相点呈升高趋势 ,与正常对照组和A组比较 ,其差异具有显著性意义 (P <0 0 5～ 0 0 1) ;B组和C组患者血中IL 12水平在烧伤早期呈下降的趋势 ,与A组和正常对照组比较 ,其差异具有显著性意义 (P <0 0 5～ 0 0 1) ,但在烧伤中后期则呈上升趋势 ;血浆LPS主要与血清中TNF、IL 1β、IL 6、IL 8、IL 18水平呈显著正相关 (P <0 0 5～0 0 1)。结论 烧伤后内毒素直接或间接影响机体细胞因子。
Objective To investigate the effect of endotoxins on the levels of cytokines and soluble adhesion molecule and sFas/ sFasL in patients with severe burn.Methods Twenty-eight patients with a total burn surface area of 30% or more were collected, and the forty healthy volunteers served as control group. The levels of LPS, cytokines (TNF-α,IL-1β,IL-6,IL-8,IL-12,IL-18), soluble adhesion molecule (ICAM-1 and VCAM-1) and sFas/ sFasL were measured in the blood of severe burned patients at various time points ( 1, 3, 5, 7, 14, 21, 28 and 35 days after burn). They were divided into three groups according to the levels of LPS: group A(0～0.200 EU/ml), group B(0.200～0.400 EU/ml),and group C(>0.400 EU/ml). Results In comparison with group A and control group, the levels of TNF-α,IL-1β,IL-6,IL-8 , IL-18 and ICAM-1 in group B and groups C increased significantly (P<0.05～0.01) at various time points, whereas the levels of VCAM-1 and sFas/sFasL were high at several time points. However, in the group B and groups C, the levels of IL-12 decreased markedly at first (P<0.05～0.01), but rose later. The level of LPS was significantly positive correlated with that of TNF-α,IL-1β,IL-6, IL-8, IL-18 at various time points (P<0.05～0.01).Conclusion The productions of cytokines and soluble adhesion molecule and sFas/sFasL are directly or indirectly influenced by the LPS after burn,and it is associated with the course of diseases.
出处
《中华急诊医学杂志》
CAS
CSCD
2004年第7期470-473,共4页
Chinese Journal of Emergency Medicine
