摘要
目的 探讨术后并发严重感染患者血清 E-选择素(E- SL T)和 s CD14的变化情况及其与病情预后的关系 .方法 采用 EL ISA于术前和术后测定 37例手术和 30例健康志愿者血清 E- SL T、s CD14及 TNF- α的浓度 .结果 E- SL T水平在未并发感染组于术后 1d开始增高 ,术后 3d达高峰 (15 1± 12 )μg· L- 1 ,4d后开始下降 ,至 2 5 d接近正常水平 (4 0±10 ) μg· L- 1 ;在并发严重感染组 E- SL T水平于术后 1d开始增高 (6 8± 9)μg· L- 1 ,至术后 2 5 d时仍处于高水平状态 (32 8± 5 4) μg· L- 1 .s CD14水平在未并发感染组于术后 1d开始增高 ,4d后开始下降 ,至 2 5 d接近正常水平 (1.0 3± 0 .16 )mg· L- 1 ;在并发严重感染组 s CD14水平于术后 1d开始增高 ,至术后 2 5 d仍处于高水平状态 (2 .6 3± 0 .82 ) mg· L- 1 .s CD14与 TNF- α者间的相关系数为 r=0 .896 ,P<0 .0 5 .结论 s CD14和 TNF-α在术后并发严重感染的早期病理过程中起着重要的作用 ,s CD14与早期感染密切相关 ;E-选择素可能在感染病理变化过程的后期起着重要的作用 ,与感染严重程度相关 . E- SL T和 s
AIM To investigate the changes in serum levels of E-selectin, soluble CD14 (sCD14) and TNF-α, as well as their relationship between infection and prognosis in postop-erative patients complicated by severe infection. METHODS Serum E-selectin and sCD14 and TNF-α levels in 37 postoperative patients and 30 controls ones were measured by ELISA before and after operation. RESULTS The level of E-selection in patients without infection began to rise on d 1 after the operation and reached the hightest level [(151±12) μg·L -1] on d 3. Then it started to reduce on d 4 till the d 25, it was close to normal [(40±10) μg·L -1], while in patients with severe infection, the level of E-selection began to go up d1 after the operation [(68±9) μg·L -1], and remained high [(328±54) μg·L -1] even on d 25 after the operation. The level of sCD14 in patients without infection began to increase d 1 after the operation and started to reduce on d 4 till the d 25 it became close to normal [(1.03±0.16) mg·L -1]; while in patients with severe infection, the level of sCD14 began to go up and reached the highest level [(2.63±0.82) mg·L -1] on d 25. The correlation coefficient (r) in the serum levels of sCD14 and TNF-α were 0.896, P<0.05. CONCLUSION sCD14 and TNF-α may play an important role during early process of infection and sCD14 is closely related to the occurrence of infection. E-selectin, is important in the mechanism of pathogenesis and might be closely related to the severity of secondary infection during late pathophysiologic process of infection. Increased serum concentration of sCD14, TNF-α, E-selectin are part of good prognostic markers on postoperative patients complicated by severe infection.
出处
《第四军医大学学报》
北大核心
2002年第6期555-558,共4页
Journal of the Fourth Military Medical University
