严重多发伤患者血清TNF-α,IL-6、IL-8的变化及意义

Clinic value of serum TNF-α and interleukin-6,interleukin-8 on seriously multiple traumatic patients

目的 探讨在严重创伤患者发病过程中肿瘤坏死因子TNF α,白介素IL 6、8的变化意义。方法 随机选择 4 0例多发伤患者 ,治疗中有 1 7例发生多脏器功能不全综合征 (MODS) ,其余 2 3例未发生MODS。在入院后各时段测定其血清肿瘤坏死因子TNF α,白介素IL 6、8水平 ,比较MODS组和非MODS组测定值的差别。结果 发现非MODS组患者TNF α,IL 6、8的表达在伤后早期即升高 ,2～ 3d后达高峰后开始下降 ,康复时恢复正常、而并发MODS者 ,以上值的早期上升幅度更明显、持续时间长、且出现高峰在伤后 7～ 1 0d。两组在伤后第 2天有明显差异 ,在第 4、7、1 0天有显著性差异。结论 TNF α,IL 6、8的促炎因子在全身性炎症反应综合征 (SIRS)中起着重要的作用 。

Objective To evaluate the post traumatic changes of serum levels of IL 6,IL 8 and TNF α and their relationship to the occurrence of multiple organ dysfunction (MODS).Methods Fourty cases with seriously multiple injury were selected to measure the serum level of IL 6,IL 8 and TNF α on 12 hours,2,4,7 and 10 days after trauma.Results It was found that MODS occurred in 17 cases of the 40 cases.The levels of TNF α and IL 6,IL 8 were increased significantly in MODS group in 2 days ( P <0.05),especially from 4 th to 10 th day ( P <0.01).They returned to normal levels about 1 week after trauma in traumatic group,but maintained at a higher level for a longer time in MODS group.Conclusion It was demonstrated that TNF α and IL 6,IL 8 might be an important factors promoting the development of SIRS to MODS in multiple injury patients.