摘要
目的:阐明TNF-α、可溶性E-选择素、L-选择素、ICAM-1、TGF-β1在肾综合征出血热(HFRS)发病机制中的作用。方法:34例HFRS患者(轻症组19例,重症组15例)按病期采血,分别用放射免疫法和ELISA检测TNFα、E-选择素、L-选择素、I-CAM-1和TGF-β1,并同期作肾功能和血常规检查。结果:从发热期至多尿期,血清TNF-α、E-选择素、L-选择素和ICAM-1水平均显著增高,而TGF-β1显著降低,TNF-α与BUN呈一致性变化趋势,而与血小板的变化趋势相反。结论:TNF-α、E-选择素、L-选择素、ICAM-1等细胞因子在肾综合征出血热发病机制中起重要作用,而TGF-β1水平下降可能是造成失控性全身炎症反应和多器官功能障碍综合征的重要因素之一;合理的对症治疗和适量使用免疫调节剂可望改善本病的预后。
Objective： To evaluate the role of tumor necrosis factor-or （TNF-α）, E-selectin, L-selectin, intercellular adhesion molecule-1 （ICAM-1） and transforming growth factor-β1（TGF-β1） in the pathogenesis of hemorrhagic fever with renal syndrome（HFRS）. Methods： Blood samples from 34 patients with HFRS （19 of moderate type, 15 of severe type） were detected by radioimmunoassay for TNF-α and by ELISA for E-selectin,L-selectin,ICAM-1 and TGFβ-1 respectively. Meanwhile blood urea nitrogen （BUN） and platelet count were examined synchronally. Results： During the course from febrile stage to polyuric stage of HFRS, serum levels of TNF-α,E- selectin, L-selectin and ICAM-1 were significantly increased while TGF-β1 were significantly decreased as compared with control group （P 〈 0.05-0.01 ）. The curve of TNF-α was similar to that of BUN, but contrary to that of blood platelet count. Conclusion： TNF-α ,E-selectin,L-selectin and ICAM-1 may play an important role in the pathogenesis of HFRS, and the decreased serum level of TGFβ-1 appears to be an important factor leading to uncontrolled systemic inflammatory reaction and multiple organ dysfunction syndrome （MODS）, therefore, the combination of reasonable symptomatic therapy with immunoregnlator would improve the prognosis of HFRS.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2006年第8期676-679,共4页
Journal of Nanjing Medical University(Natural Sciences)
