下肢严重创伤患者血清TNF-α及IL-6的表达及其临床伤情判断价值

Expression and Clinical Traumatic Condition Judgment Value of Serum TNF-α and IL-6 Levels in Patients with Severe Lower Extremity Trauma

目的探讨下肢严重创伤患者TNF-α及IL-6血清浓度的动态变化及其对下肢严重创伤患者伤情判断的意义。方法 2005年1月至2009年12月下肢严重创伤患者31例,按下肢创伤严重度评分(mangled extremity severity score,MESS)为(6.24±1.45)分,MESS<7分26例,MESS≥7分5例。在伤后第6h及入院后第1、3、5、7、10、14和21d分别采集静脉血标本,应用ELISA法测定31例下肢严重创伤患者伤后血清TNF-α和IL-6水平变化,并与20例健康对照比较,以判断PCT水平变化与下肢严重创伤严重程度和预后之间的关系。结果 TNF-α及IL-6血清浓度在下肢严重创伤后均较正常对照组显著增高,TNF-α于2周后恢复正常,而IL-6增高持续至2周后。各下肢创伤严重度评分(MESS)分值区段内的创伤患者TNF-α及IL-6水平有显著差异(P<0.05),二者之间存在正相关性。结论动态检测下肢严重创伤患者外周血TNF-α和IL-6的水平变化可有助于病情的评估及预后判断。

Objective To explore the dynamic changes of serum TNF-α and IL-6 levels and the clinical significance between the changes of serum TNF-α and IL-6 levels and traumatic condition judgment in patients with severe lower extremity trauma.Methods A retrospective study was carried out in 31 cases with severe lower extremity trauma from January 2005 to December 2009.Mangled extremity severity score（MESS） was（6.24 ± 1.45） in all the cases,among which there were 26 cases with MESS7 and 5 cases with MESS≥7.Blood samples were collected at 6 h after trauma and 1,3,5,7,10,14 and 21 d after admission.TNF-α and IL-6 were measured by enzyme-linked immunosorbent assay（ELISA） in serial samples of serum from 31 patients and compared with those of 20 normal control volunteers.Results TNF-α and IL-6 levels in patients with severe lower extremity trauma were obviously higher after the injury,TNF-α was returned normal,but IL-6 was still in the high levels after two weeks.TNF-α and IL-6 levels of the trauma patients in score sections of MESS were significantly different（P0.05）,there was positive correlation between the two.Conclusion To investigate the changes of serum TNF-α and IL-6 levels in patients with severe lower extremity trauma is helpful for evaluation of disease and prognosis.