重症肺炎血清可溶性肿瘤坏死因子受体检测的临床意义

The clinical significance of detecting soluble tumor necrosis factor receptors in children with severe pneumonia

目的 研究重症肺炎患儿血清可溶性肿瘤坏死因子受体（ Ｓ Ｔ Ｎ Ｆ Ｒ） 浓度变化。方法 采用 Ｅ Ｌ Ｉ Ｓ Ａ 方法测定２７ 例肺炎（１５ 例重症肺炎） 患儿极期与恢复期血清 Ｓ Ｔ Ｎ Ｆ Ｒ 浓度，并进行危重评分。结果 肺炎时血清 Ｓ Ｔ Ｎ Ｆ Ｒ 升高，极期重症肺炎明显高于普通肺炎，随病情改善血清浓度下降； Ｔ Ｎ Ｆ 改变不明显，随着病情好转无显著下降。 Ｓ Ｔ Ｎ Ｆ Ｒ 水平与肺炎疾病危重评分呈负相关。结论 小儿肺炎时血清 Ｓ Ｔ Ｎ Ｆ Ｒ 明显升高，且与疾病危重程度密切相关； Ｓ Ｔ Ｎ Ｆ Ｒ 有助于临床指导肺炎的治疗与观察预后。

Objective To investigate the changes of STNFRs concentrations in serum of children with sereve pneumonia.Methods The serum concentrations of STNFRS at active and recovering stage were detected with ELISA in 27 children with pneumonia,of which 15 cases were severe and 12 were mild and we estimated the score of severity.Results The STNFRs concentrations in serum were also elevated,and at the active stage,they were considerably higher in the severe pneumonia than those of mild pneumonia;they decreased when pneumonia was recovering.The changes of TNF were not significant,unlike STNFRs,TNF didn′t decline when the disease was getting better.The concentrations of STNFRs in serum were inversely related to the score of the severity.Conclusions The concentrations of STNFRs in serum were elevated notably,and were inversely related to the score of severity;The ditecting of STNFRs is helpful for guiding the treatment and estimating the prognosis.