多脏器衰竭患儿血清磷脂酶A_2及肿瘤坏死因子水平的研究

Study on Serum Phospholipase A_2 and TNF-α Levels in Children with Multiple Organ Failure

采用ELISA法检测了脏器衰竭患儿36例，健康儿20例血清磷脂酶A2（PLA2）及肿瘤坏死因子（TNF－α）含量，并监测病儿脏器功能及动脉血气，探讨血清PLA2及TNF－α在多脏器衰竭（MOF）发生、发展中的作用及意义。结果：血清PLA2及TNF－α含量在MOF组明显高于单衰组，死亡组显著高于治愈组（P＜0.05）；PLA2与TNF－α、动脉血氧分压呈相关关系。提示：PLA2及TNF－α参与了MOF病理过程，动态监测血清PLA2及TNF－α对MOF判断及预后评估等均有指导性的临床意义。

To evaluate the role and significance of serum phospholipase A_2(PLA_2)and TNF-α in the development of multiple organ failure (MOF) in children, the serum concentrations of PLA_2 and TNF-α were determined in 36 children with organ failure and 20 healthy children by ELISA method. The arterial blood gases were measured while the organ functions were simultaneuosly evaluated. Results: The mean serum concentratons of PLA_2 and TNF-α in MOF were signiflcantly higher than those in single organ failure(P＜0.01). The sean concentrations of PLA2 and TNF-α in the fatal patients were signigicantly higher than those in the cured patients (P＜0.01). The serum PLA2 and TNF-α levels correlated directly with the arterial PO2. Our results demonstated that the PLA_2 and TNF-α involved in the pathophysiologlc process of MOF. Monitoring the serum PLA_2 and TNF-α change may provide us significant parameters to alert the MOF development,to evaluate the therapeutic response and to predict outcome of the patient.