肺炎并发呼吸衰竭患儿血清肿瘤坏死因子及循环内皮细胞的改变

The changes of the circulating endothelial cells and tumor necrosis factor in pneumonia with respiratory failure

检测３９例肺炎及合并呼衰或ＭＳＯＦ患儿血清ＴＮＦａ及ＣＥＣ数，血糖及乳酸，结合临床监护，结果发现ＴＮＦａ及ＣＥＣ数，呼衰组明显高于肺炎组（Ｐ＜０．０１），而ＭＳＯＦ组明显高于呼衰组（Ｐ＜０，０１）。提示肺炎时ＴＮＦａ可能是其恶化的始动因素，而血管内皮损伤是其关键环节；ＴＮＦａ及ＣＥＣ数与危重度评分高低，疾病轻重，脏器功能不全程度密切相关。因此在预测肺炎发生呼衰时除ＰａＯ２及ＰａＣＯ２，ＴＮＦａ及ＣＥＣ数或许是另一重要数据。

The circulating endothelial cells(CEC).tumor necrosis factor(TNF), Glycemia and Lacticemia of 39 children with pneumonia were assayed. Levels of TNF - and CEC count from the patients with respiratory failure(1.45± 0.18μg/l,11.50 ±1.41 × 106/l) were higher than those of children with pneumonia (0.97±0.25,7.05 ±0.17, p<0.01),but Lower than those of groups of Multiple Systems Organ Filure(MSOF) (2.23 ±0.39,19.14±2.53.P<0.01). TNF- x was obviously related to CEC count (r=0.796,p<0.05). Glycemia and Lacticemia from patients with respiratory failure were almost similar to those of patients with MSOF were obviously increased (11.82±3.34,7.69 ±0.84mmol/1,P<0.001) lt suggested that TNF - x may be involved in the prognoses of respiratory failure and the damages of vessel endothelial cells (VEC) may he a key factor ,when pneumonitis exists and TNF - x and CEC count are colsely related to the emergency scores.degrees of illness and organ dysfunctions.