轮状病毒感染肠黏膜损伤与肿瘤坏死因子关系的研究

Relationship between the level of serum TNF-α and intestinal mucosa lesions of rotavirus infected infants

目的探讨婴幼儿轮状病毒感染时，肠黏膜损伤程度及血清肿瘤坏死因子（TNF-α）在疾病发展不同时期的改变。方法将85例患儿分为2组，观察小肠电镜下肠黏膜的损伤程度；实验室采用双抗体夹心法，检测患儿血清TNF-α含量。分别采用两种方法治疗，治疗组（45例）给予静脉补液和金双歧口服，思密达灌肠治疗，对照组（40例）只给予静脉补液，观察两组疗效。结果发病时间〈72h患儿的肠黏膜脱落面积较广泛，黏膜充血、水肿明显，血清TNF-α含量明显高于发病时间〉72h组及恢复期患儿，差异有统计学意义（P〈0．01）。金双歧、恩密达治疗组与对照组疗效比较差异有统计学意义（P〈0．05）。结论轮状病毒感染发病早期肠黏膜损伤较重，血清TNF-α水平较高；给予相应的治疗后肠黏膜病变减轻，血清TNF-α值下降，说明血清TNF-α对病情严重性判断及治疗有临床指导意义。微生态调节剂联合黏膜屏障功能制剂治疗轮状病毒性肠炎疗效明显，值得临床推广。

Objective To explore the changes of degree of intestinal mucosa lesions and serum TNF-α levels in different stages of rotavirus infection in Infants. Methods 85 infants infected with rotavirus were divided into two groups： therapy group（ n =45） was treated with intravenous fluid infusion plus enema with administration of bifico and dioctahedral smectite; control group （ n = 40） was only treated with intravenous fluid infusion. The efficacy of the treatment was observed in the two groups. Pathological lesions of intestinal mucosa were observed using electro microscope, and serum TNF-α levels were determined by double antibody sandwich method. Results Trichomadesis area of intestinal mucosa of the patients who had the infection for less than 72 hours was much larger-than that of the patients who had the infection for more than 72 hours and the patients who were in the process of recovery. , At the same time, there was obviously mucosa congestion, edema in the intestinal mucosa. Serum TNF-α levels were also higher than those of patients who had the infection for more than 72 hours and the patients who were in the process of recovery （ P 〈0. 01 ）. The TNF-α level of the therapy group was also higher than that of the control group . Conclusion The more serious the intestinal mucosa lesion is, the higher the serum TNF-α level is. These findings suggest serum TNF-α level in the infants with rotavirus infection can indicate the degree of the disease and guide the clinical therapy. Microecoregulatory agent combined with treatment of mucosa barrier function can effectively treat the enteritis caused by rotavirus infection. Therefore, it could be widely performed in clinic.