重度多发性创伤患者血清白介素-6及肿瘤坏死因子与多器官衰竭的关系

Dynamics of interleukin-6 and tumor necrosis factor alpha in patients with severe multiple trauma and their relationships to multiple system organ failure

选择8例重度多发性创伤患者,根据创伤后是否接受手术分为创伤手术组,非手术组。动态观察受伤当日,伤后第3、10、20天血清白介素-6(LL-6)以及肿瘤坏死因子(TNF_α)水平的变化,且与腹部外科选择性手术组进行了比较,分析了创伤后感染性并发症发生率及创伤后LL-6、TNF_α的变化与多器官功能衰竭的关系。结果表明多发性创伤患者从受伤当日至出院前细胞因子IL-6、TNF_α明显升高,而发展为多器官功能衰竭者两者水平升高更明显。

In order to evaluate the post-traumatic changes of serum levels of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF_α) and their relationship to the occurance of multiple system organ failure (MSOF), 80 adult patients with severe multiple trauma(SMT), injury severity score(ISS) 32±14. served as the tested subjects. of which 50 cases received operations and the other did not. Thirty adult patient, scheduled for elective abdominal surgery, were randomly chosen as trauma control, and 20 healthy blood donors acted as normal control. The venous blood samples were taken on that day of injury, 3, 10 and 20 days post-traumatically, and immediately before dis charge. to measure serum concentrations of IL-6 by immunocytochemistry method and TNF_α by enzymo-immunoassay, respectively. The diagnosis of post-traumatic MSOF was made according to Baue's criteria. As compared with normal control levels, the concentrations of IL-6 and TFN_α, increased significantly in patients with SMT(P<0.05) during the whole observation, those of trauma control kept statistically unchanged during perioperation (P>0.05). In comparison correspondingly with those of trauma control, the levels of IL-6 and TFN_α were elevated markedly (P<0.05). In patients with SMT. the concentrations of IL-6 and TFN_α were remarkablely higher with the complication of MSOF than those without MSOF(P<0.05). additionally. the incidence of MSOF positively was correlated with the levels of IL-6(r=0.9862, P<0.01) and TNF_α(r=0.9999, P<0.01). It is suggested that the concentrations of IL-6 and TNF_α may remaine high following SMT and increase further with complication of MSOF. and the elevation of them may play a important role in onset of MSOF.