摘要
目的 探讨严重创伤后血清内毒素、TNF α、IL 1 β、IL 6、IL 8的变化及其意义。方法 应用动态浊度法和放射免疫法检测 34例严重创伤患者 ,动态观察伤后 1周内血清内毒素、TNF α、IL 1 β、IL 6、IL 8的变化 ,并与正常健康人进行比较。结果 严重创伤患者伤后血清内毒素、TNF α、IL 1 β、IL 6、IL 8的的水平较正常人有明显升高 ,内毒素、TNF α、IL 1 β分别于伤后第 2、3天达高峰 ,随后下降 ,第 7天仍明显高于正常人 ;IL 6、IL 8早期即有升高 ,伤后 5～ 7d升高明显 ,且有继续上升趋势 ;严重创伤患者伤后血清内毒素、TNF α峰值水平、伤后第 5天IL 6升高幅度与ISS评分呈显著正相关 ;死亡患者血清中内毒素、细胞因子较存活者相应时间显著升高。结论 创伤后能引起明显的内毒素血症和细胞因子反应 ,动态观察可能与病情发展程度。
Objective To investigate the changes of endotoxin,TNF α,IL 1β,IL 6 and IL 8 in the serum of patients with severe trauma and to explore the clinical significance.Methods Concentration of endotoxin in the serum of patients was measured by dynamic turbidity and TNF α,IL 1β,IL 6 and IL 8 were determined by radiommunoassay respectively in a week post trauma.Normal group was observed simultaneously.Results Serum endotoxin and cytokines in patients with severe trauma were shown to be significantly higher than healthy group.Endotoxin,TNF α and IL 1β were elevated at the early stage of trauma,peaked in 2 nd and 3 rd day respectively,significantly higher than normal in 7 th day.IL 6 and IL 8 were elevated more in 5 th to 7 th day than at the early stage,and had a rising trend.The ISS scores of patients were significantly correlated with the peaks of endotoxin and TNF α,the rate of increase of IL 6 in 5 th day after trauma.Endotoxin and cytokines in death group were higher than in survivor group in corresponding time point.Conclusions Severe trauma could induce marked endotoxemia and cytokine responses.To analyze trauma patient′s condition and prognosis could be beneficial from dynamic of endotoxin and cytokines.
出处
《重庆医学》
CAS
CSCD
2003年第12期1679-1681,共3页
Chongqing medicine
