外科感染病例TNF动态变化的临床评价

THE DYNAMIC VARIATION OF TUMOR NECROTIZING FACTOR (TNF) IN 40 SURGICAL SEPTIC PATIENTS AND IT'S CLINICAL EVALUATION

本文以TNF为指标,对40例外科感染患者在治疗前后进行连续检测,结果提示:治疗前绝大多数患者血清TNF及经LPS诱生的TNF含量均无显著增高,与正常对照组比较,差异显著(P<0.001)。术后24小时和7天TNF含量虽有下降趋热,但与治疗前相比均显著差异,表明手术本身对TNF的产生影响不大。患者痊愈后TNF降至正常参考值水平。提示TNF恢复至正常值平均约需13天,迟于临床病情的改变。据此认为测定血清TNF可作为早期诊断和判断感染程度的一项指标,也可作为停用抗生素的指标。

The serum TNF levels were determined consecutively in 40 Surgical Septic patients before and after the treatment. The result showed that the serum TNF levels and the levels induced by LPS were markedly elevated before operation in great majority of cases, comparing with the normal value in control group, the variance had stastic significance (P<0. 001). The levels determined 24 hours after operation and on the sevent day after treatment showed a declining tendency, but comparing with levels before treatment, there was no significant defference. After recovery the TNF levels reached the normal reference value about 13 days after operation. Its reduction lagged after the clinical recovery. The determination of serum TNF may be applicable for early diagnosis and clinical evaluation of the severity of the surgical sepsis. It can also be used as a guide for prognosis and termination of antibiotic therepy.