创伤性MODS患者血可溶性白细胞分化抗原14与内毒素比值变化

Changes of plasma ratios of sCD14 to LPS in patients with traumatic MODS

目的探讨创伤多器官功能不全综合症(MODS)患者血浆可溶性白细胞分化抗原14与内毒素比值(sCD14/LPS)变化及其临床意义。方法测定正常对照组,创伤MODS生存组和MODS死亡组血浆sCD14和LPS的摩尔浓度含量,并计算sCD14和LPS比值。观察创伤MODS患者血浆sCD14/LPS变化及其与主要器官功能受损指标的关系。结果创伤性MODS各组血浆sCD14,LPS均明显高于正常对照组(P<0.01),且创伤MODS死亡组LPS明显高于创伤MODS生存组(P<0.01),但sCD14与创伤MODS生存组没有显著差别。创伤MODS生存组sCD14/LPS与正常对照组无显著差异,MODS死亡组sCD14/LPS明显低于MODS生存组(P<0.01)。创伤MODS患者血sCD和LPS水平均与血谷丙转氨酶、肌酐和二氧化碳分压明显正相关(P<0.01),但sCD14/LPS与血谷丙转氨酶、肌酐和二氧化碳分压明显负相关(P<0.01)。sCD14/LPS与血谷丙转氨酶、肌酐和二氧化碳分压相关系数绝对值最大。结论创伤性MODS患者血sCD14浓度升高幅度不如LPS。sCD14/LPS比值可能作为判断MODS患者器官功能不全程度及预后转归的预警指标。

Objective To study the clinical significance of the changes of plasma sCD14/LPS in orients with traumatic MODS. Methods The levels of sCD14 and LPS in plasma of patients in MODS-survival, MODS-dead, and control groups were assayed. The ratio of sCD14 to LPS was calculated and the correlation coefficient between the ratio and index of MODS was statistically analyzed. Results The levels of sCD14 and LPS in MODS-survi-val and MODS-dead groups were higher than those in control group. The ratios of sCD14 to LPS in MODSsurvival and control groups were no significant difference. The ratio of sCD14 to LPS in MODS-dead group was lower than that of MODS-survival group （ P 〈 0.01 ）. There are negative correlation between the ratios of sCD14 to LPS and index of MODS （ P 〈 0.01 ）. Conclusion Our data suggest that the traumatic MODS patients represent the deficiency of sCD14 as compared to the high level of LPS. The changes of the ratio of sCD14 to LPS may be used to diagnosis and evaluate the degree of the MODS severity of traum patients.