危重病患者血清粒细胞集落刺激因子变化的意义

Changes of serum granulocyte colony stimulating factors in critical patients

目的 :探讨危重病患者血清粒细胞集落刺激因子 (G CSF)变化的意义。方法 :采用双抗体夹心酶联免疫法 (ELISA法 )测定 67例急性危重病患者血清G CSF水平 ,并与 2 9例体检健康者进行对照分析。结果 :对照组血清G CSF均为阴性 ,危重病组G CSF阳性率为 4 7.8% ,其中感染组、创伤组、中风组阳性率分别为 66.7%、3 1.6%和 3 3 .3 % (与对照组比较 ,P均小于 0 .0 0 5 )。感染组阳性率高于非感染 (创伤或中风 )组 (P<0 .0 5 )。G CSF阳性组中 ,感染病例占 62 .5 % ,外周血白细胞大于 2 0× 10 9/L者占 71.9% ;而G CSF阴性者中 ,感染病例占 2 8.6% (P <0 .0 1) ,WBC >2 0× 10 9/L占 3 1.4 % (P <0 .0 0 5 )。 8例G CSF阳性患者中有 5例于病情恢复后转为G CSF阴性 (占 62 .5 % )。结论 :危重病患者血清G CSF水平增高 ,尤其以感染患者较明显。早期测定危重病患者G CSF对细菌感染与非细菌感染的鉴别、治疗具有一定的参考价值。

Objective:To explore the change of serum granulocyte colony stimulating factor (G CSF) in critical patients.Methods:The levels of serum G CSF were measured with ELESA kit in 67 critical patients and 29 age matched healthy cases (control group).Results:The positive rate of serum G CSF was 0% in control group, but it's 47.8% in critical group (P<0.005). The positive rates were 66.7%, 31.6% and 33.3% in infectious group, trauma group and stroke group, which were all significantly higher than control group (P<0.005). The positive rate was significantly higher in infectious group than in non infectious (trauma or stroke) group (P<0.05). The infectious patients accounted for 62.5% and the patients of peripheral white blood cell count (WBC)>20×10 9/L accounted for 71.9% in cases of positive G CSF, but those accounted for 28.6% (P<0.01) and 31.4% (P<0.005) in cases of negative G CSF. On convalescence stage 5 cases returned to negative in 8 cases of positive G CSF (62.5%).Conclusion:The levels of serum G CSF were significantly higher in critical patients, which was highest in infectious group. Measuring serum G CSF at early stage in critical patients may be useful in distinguishing the infectious disease from non infectious and may be helpful in the treatment.