MODS患者血清多种细胞因子、C反应蛋白和D-二聚体水平的意义以及与预后的关系

Serum levels of TNF-α, IL-6, IL-10, CRP and D-dimer in patients with multiple organ dysfunction syndrome

目的 :探讨肿瘤坏死因子 -α(TNF -α)、白介素 6 (IL - 6 )、白介素 10 (IL - 10 )、C反应蛋白 (CRP)和D-二聚体 (D -dimer)在多器官功能障碍综合征 (multipleorgandysfunctionsyndrome ,MODS)的变化特点以及对预后的影响。方法 :应用ELISA方法检测 2 7例MODS患者第 1d、3d和第 5d的血清TNF -α、IL - 6和IL - 10水平 ,同时检测CRP和D -dimer水平 ,并以 15例正常健康成人体检者的水平作为正常对照。并比较 8例死亡患者和 19例治愈患者第 1d的水平。结果 :所有MODS患者自第 1d血清TNF -α、IL - 6、CRP和D -dimer均明显高于正常对照组 (P <0 0 5 ) ,且随病情的发展水平逐渐升高 ,而IL - 10的水平在第 3d开始升高。死亡组第 1d的水平高于治愈组 ,以IL -6和D -dimer较明显。结论 :血清TNF -α、IL - 6、IL - 10、CRP和D

AIM: To determine the changes of the serum levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), IL-10, C reactive protein (CRP) and D-dimer in the patients with multiple organ dysfunction syndrome (MODS) and compare the relationship between the levels of cytokines in early stage and MODS. METHODS: The serum values of TNF-α, IL-6, IL-10, CRP and D-dimer were measured in 27 patients with MODS in 1 d, 3 d and 5 d after undergoing disease, and compared with the adult peripheral blood of 15 normal controls. The levels in the first undergoing day between the lived group (n=19) and died group (n=8) were compared. RESULTS: The serum levels of TNF-α, IL-6, IL-10, CRP and D-dimer in MODS group were higher than that in control (P<0.05). With the development of the MODS, the levels of TNF-α, IL-6, IL-10, CRP and D-dimer were higher gradually. The level of IL-10 was increased at the third day. The levels of TNF-α, IL-6, IL-10, CRP and D-dimer in the first day of MODS in died group were higher than those in lived group, especially IL-6 and D-dimer (P<0.01). CONCLUSION: Determining the serum levels of TNF-α, IL-6, IL-10, CRP and D-dimer in MODS patients is helpful to guide the diagnosis and outcome. [