多系统脏器衰竭和败血症患者肿瘤坏死因子和白细胞介素6的水平和意义

Prognostic value of tumor necrosis factor and interleukin-6 in patients with multiple system organ failure and septicemia

应用单克隆抗体的ELISA法检测12例多系统脏器衰竭(MSOF)患者、14例败血症患者血清肿瘤坏死因子(TNF)水平,同时应用MTT比色法测定患者血清白细胞介素6(IL-6)活性。结果:MSOF和败血症患者的TNF和IL-6水平明显高于正常(P均<0.01),两者的升高呈显著相关(r=0.68),并且伴有高乳酸血症。MSOF患者TNF和IL-6水平与生存率成反比,死亡组(n=5)均高于生存组(n=7),P均<0.01。败血症患者的生存率与TNF水平成反比且伴高乳酸血症。上述研究表明:TNF与IL-6在MSOF的发病过程中起着重要作用,同时也是判定MSOF和败血症患者预后方面的重要指标。

Tumor necrosis factor(TNF)and inter-leukin-6(IL-6)are the main mediators involved inthe pathophysiology of multiple system organ fail-ure(MSOF)and septicermia.Using a senstiveenzyme-linked immunosorbent assay(ELISA),wemeasured serun TNF levels in 12 MSOF patientsand 14 patients with septicemia.At the same time,sreum IL-6 levels were measured in the same pa-tients using MTT chromatometry.The resultsshowed:(1)TNF and IL-6 levels in patients withMSOF and septicemia significantly nigher thannormal individuals(P<0.001 respectively).TNFlevel was positively correlated with IL-6 level(r=0.68,P<0.05).Basides.hyper lactlcemia wasfound to be concomitant with the elevation of TNFand IL-6.(2)In MSOF patients,TNF and IL-6levels were significantly higher in those who died(n=5)than those who survived(n=7)(P<0.01respectively).There were inverse ratio betweenTNF,IL-6 levels and the survival rate in MSOFpatients.(3)TNF level was inversely proportionalto the survival rate in septicemic patients,in whomaccompanied hyper lacticemia was found propor-tional to the survival rate.This study demonstratedthat circulating TNF and IL-6 were closely relatedto the pathophysiology of MSOF and septicemia,also,TNF and IL-6 are important tests in pre-dicting the prognosis of the patients with MSOFand septicemia.