肿瘤坏死因子在急性胰腺炎及并发多器官衰竭中作用的研究

The role of tumor necrosis factor in acute pancreatitisand asseeiated multiple organ failure

作者对３２例急性胰腺炎患者（水肿型１５例，坏死型１７例，多器官衰竭８例），血液中肿瘤坏死因子（ＴＮＦ）、氧自由基（ＯＦＲ）以及内毒素血症在急性胰腺炎病程发展中的作用进行了研究。结果表明ＴＮＦ和ＯＦＲ在急性胰腺炎患者中含量增高（与正常对照组相比Ｐ＜０．０５），并与临床症状的变化相一致。ＴＮＦ与早期多器官衰竭（ＭＯＦ）的发生有关。ＴＮＦ和ＯＦＲ都参与晚期ＭＯＦ的发生和发展。内毒素血症在急性胰腺炎的早期不是一个主要因素，而在晚期因其可刺激ＴＮＦ、ＯＦＲ的产生而成为ＭＯＦ发生的始动因子。

n 32 patients with acute pancreatitis (AEP= 15 .ANP = 17 ) , tumor necrosis factor (TNF)activity,oxygen-derived free radicals (OFR) and endotoxincontents were determined by L929 cell bioassay, Te-trabarbituric acid fluorometry and Limulus test respec-tively. The results showed that TNF and OFR elevat-ed in patients with AP at the admission (P<0. 05 vsnormal). The change of TNF and OFR responded tothe clinical symptoms. TNF correlated to early multi-ple organ failure (MOF). In patients with late MOF.TNF and OFR were both the important factors. Bymeasuring endotoxin, we found that endotoxemiaewere not so important in early phase of the disease asin late phase, in which they made TNF and OFR re-leased profusely.