摘要
目的探讨在多器官功能衰竭综合征(MODS)患者中细胞因子TNF-α和血管内皮细胞功能标志物的变化。方法动态观察MODS及非MODS患者一氧化氮(NO)、内皮素(ET-1)、组织纤溶酶原激活物(t-Pa)、纤溶酶原激活物抑制物-1(PAI-1)、循环内皮细胞(CEC)、肿瘤坏死因子(TNF-α)的浓度,同时给予Marshall评分。结果与非MODS组相比,MODS组、死亡组的TNF-α、ET- 1、PAI-1、CEC、Marshall评分显著升高(P<0.05),而NO、t-Pa显著降低(P<0.05)。结论TNF-α作为炎性因子在MODS的进展中起重要作用;在MODS时内皮细胞的损伤表现为ET-1、PAI-1、CEC增加,NO、t-PA减少,Marshall评分对于危重症患者的评估是敏感指标。
Objective To study the changes of vascular endothelial functional status and cytokine TNF-α in patients with multiple organ dysfunction syndrome (MODS). Methods Plasma levels of tissue plasminogen activator (t-Pa), plasminogen activator inhibitor-1 (PAI-1 ), circulating endothelial cell (CEC) and serum levels of endothelin (ET-1 ), tumor necrosis factor- ( (TNF-α), nitric oxide (NO) were determined serially dynamically in patients with MODS and those without MODS (non-MODS). At the same time Marshall scores were evaluated. Results Blood levels of TNF-α, ET-1, PAI-1, CEC, and Marshall scores were significantly higher in MODS and succumbed (those who died) groups than those in non-MODS and survied (those who lived) groups (P 〈0.05), but blood levels of NO and t-Pa were significantly lower ( P 〈 0.05). Conclusion TNF-α played an important role in the progression of MODS. The increase of ET-1, PAI-1, CEC and the decrease of NO and t-Pa indicated endothelial dysfunction in MODS. Marshall scoring system for MODS was a sensitive parameter in evaluating the patients with MODS.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第7期581-584,共4页
Chinese Journal of Emergency Medicine