严重创伤患者白细胞介素2及其受体变化与多器官功能障碍综合征的关系

Changes of interleukin 2 and soluble interleukin 2 receptor serum level and multiple organ dysfunction syndrome in severely traumatic patients

目的 探讨血清白介素２（ Ｉ Ｌ２） 与可溶性白介素２ 受体（ｓ Ｉ Ｌ２ Ｒ） 在创伤后多器官功能障碍综合征（ Ｍ Ｏ Ｄ Ｓ） 发生、发展中的作用与机制。 方法 应用 Ｅ Ｌ Ｉ Ｓ Ａ 法动态监测５９ 例严重创伤患者血清 Ｉ Ｌ２ 与ｓ Ｉ Ｌ２ Ｒ 水平变化，比较 Ｍ Ｏ Ｄ Ｓ与非 Ｍ Ｏ Ｄ Ｓ组间 Ｉ Ｌ２ 、ｓ Ｉ Ｌ２ Ｒ 变化之差异。 结果 ５９ 例患者血清ｓ Ｉ Ｌ２ Ｒ 水平显著升高而 Ｉ Ｌ２ 明显下降，且升高之峰值与降低之谷值在 Ｍ Ｏ Ｄ Ｓ组更为明显，与非 Ｍ Ｏ Ｄ Ｓ组间差异显著（ Ｐ＜ ００５） 。 结论 Ｉ Ｌ２ 与ｓ Ｉ Ｌ２ Ｒ 血清浓度的变化可能参与了创伤后 Ｍ Ｏ Ｄ Ｓ的发病过程；严重创伤诱发血清ｓ Ｉ Ｌ２ Ｒ 过度表达进而抑制 Ｉ Ｌ２ 依赖性免疫反应，这可能是创伤后 Ｍ Ｏ Ｄ Ｓ重要发病机制之一。

Objective To evaluate the role in the changes of interleukin 2 (IL 2) and soluble interleukin 2R (sIL 2R) serum level in the mechanism of post traumatic multiple organ dysfunction syndrome (MODS). Methods 59 severe traumatic patients were divided into MODS group ( n =24) and non MODS group ( n =35) according to the occurrence of MODS after trauma. The changes in IL 2 and sIL 2R serum level were observed by enzyme linked immunosorbed assay (ELISA). Sera from 30 healthy individuals were used as normal controls. Results The serum level of sIL 2R was increased and that of IL 2 decreased in 59 traumatic patients. These changes were more marked in the MODS group than in non MODS group (p<0 05). Conclusions The changes in IL 2 and sIL 2R serum level after trauma might participate in the mechanism of post traumatic MODS.