多发伤后血清细胞因子水平的动态观察

Dynamics of serum cytokines in patients with multiple trauma

目的检测多发伤后血清中各种细胞因子的水平，探讨其意义。方法研究对象为多发创伤病人20例。于伤后1～7天，每日采空腹血样，用双抗体夹心酶联免疫法分别检测血清中肿瘤坏死因子（TNF－α），白细胞介素1β、2和6（IL－1β，2，6）及粒细胞集落刺激因子（G－CSF），并进行了动态观察。结果多发伤组TNF－α，IL－2，IL－6明显高于对照组，而且在伤情严重的病人中（创伤严重度评分ISS≥25）TNF－α和IL－α升高更为明显，G－CSF的升高与严重感染有关。伤后IL－1元升高。结论TNF－α，IL－2，IL－6参与多发伤后的病理生理过程，G－CSF升高可能是机体对伤后严重感染的反应。

Objective To investigate whether there were cytokines changes after trauma. Methods 20 patients withmultiple trauma and 10 controls were included. Age range from 19 t0 68 years old(mean age 42. 6 ), M: F = 2. 3: 1. Theblood samples were collected in 1 ～ 7 days after trauma. Serum TNF - α, G - CSF, IL - 1β, IL - 2 and IL6 monitored using ELISA. Results Serum TNF - α， IL - 2 and IL - 6 levels increased significantly in trauma patlents than in controls. And the serum TNF - α and IL - 2 increased in severe patients(ISS≥25 ). The elevation of G - CSF concentrationwas related with severe inflammatory. No IL - 1β rises in these patients. Conclusion It is suggested that TNF - α, IL 2, IL - 6 may play a role in pathophysiology after trauma. Increased G - CSF might be the response of human body tosevere infection.