摘要
目的 通过研究脓毒症患者血清促炎因子TNFα、抗炎因子IL 10的浓度水平及IL 10 /TNFα比值的变化 ,评价患者的免疫状况及其与疾病的严重程度和预后的关系。方法 在患者被诊为脓毒症后的第 1、3、5、7、14、2 1、2 8天采用Elisa法测定其血清TNFα、IL 10浓度并计算IL 10 /TNFα比值及当天的APACHE Ⅱ和SOFA评分 ,至脓毒症消失。结果 32例脓毒症患者中 ,12例死亡 ,2 0例存活。血清TNFα、IL 10水平及IL 10 /TNFα比值与APACHE Ⅱ或SOFA评分无相关性(P >0 0 5 ) ;死亡组血清IL 10水平及IL 10 /TNFα比值均明显高于存活组 (P <0 0 5 ) ,但死亡组与存活组之间的第 1天、第 3天及最后 1天血清TNFα、IL 10水平及IL 10 /TNFα比值差异无显著意义(P >0 0 5 )。结论血清IL 10水平或IL 10 /TNFα比值高的脓毒症患者 ,预后差。
Objective To monitor the changes of serum TNFα?IL-10 and IL-10/TNFα ratio in septic patients and evaluate their immunological condition, relationship between severity of illness, prognosis and TNFα,IL-10, IL-10/TNFα ratio. Methods Patients′ APACHE-Ⅱ scores, SOFA scores, and serum TNFα?IL-10 and IL-10/TNFα ratio were determined in the 1 st ,3 rd , 5 th ,7 th ,14 th , 21 st and 28 th days after the diagnosis of sepsis was made.ResultsAt the end of this evaluation, 20 cases survived and 12 cases died. There were no relationship between serum TNFα,IL-10, IL-10/TNFα ratio and the severity of illness or prognosis( P >0.05). Serum IL-10 and IL-10/TNFα ratio in the dead were significantly higher than that in the survivors( P <0.05),however the 1 st ,the 3 rd and the last day measurements of serum TNFα? IL-10 and IL-10/TNFα ratio in the survivors were same as the corresponding results in the dead( P >0.05). Conclusions The septic patients with high serum IL-10 or IL-10/TNFα ratio fared with poor prognosis.
出处
《中华普通外科杂志》
CSCD
北大核心
2003年第4期229-231,共3页
Chinese Journal of General Surgery
