严重感染患者应激相关因子的改变及临床意义

Changes of stress - related factors in severe infection patients and its clinical significance

目的探讨严重感染患者血清应激相关因子白细胞介素6（IL-6）、促肾上腺皮质激素（ACTH）、皮质醇（CO）、游离T3（FT3）、游离T4（FT4）的变化及临床意义。方法用化学发光法检测38例严重感染患者、32例重症非感染患者、32例正常人血清IL-6、ACTH、CO、FT3、FT4水平，作对比分析。结果严重感染组、重症非感染组血清IL-6、CO水平明显高于对照组（P〈0．01），ACTH、FT3、FT4水平明显低于对照组（P〈0．01）；严重感染组IL-6水平明显高于重症非感染组（P〈0．01），其他指标两组比较差异无统计学意义。结论严重感染的发生、发展过程中有多种应激相关因子参与。动态监测应激相关因子的变化，对严重感染的病理研究、病情变化的及时了解、治疗方案的选择都具有非常重要的价值。

Objective To investigate the changes of stress factors：interleukin 6 （IL -6）, adrenocorticotrophic hormone （ACTH） , cortisol （CO） , free T3 （ FT3 ） and free T4 （ FT4 ） in severe infection patients and its clinical significance. Methods To detect the serum concentration level of above five stress factors by using chemiluminescence analysis method in 38 cases of severe infection patients, 32 cases of severe non - infection patients and 32 cases of normal people. Results Serum level of IL - 6 and CO were significantly higher in severe infection group and severe non - infection group compared with control group （P 〈0. 01 ） ; serum levels of ACTH, Fr3 and VF4 were significantly lower than in control group （ P 〈0.01 ） ; IL -6 level was significantly higher in severe infection group than in severe non - infection group （ P 〈 0. 01 ）, other stress factors between two groups were not significantly different. Conclusion There are several stress factors involved in the development and progress of severe infection. In - depth study of various stress factors in the pathogenesis of severe infection and dynamic monitoring of their changes in concentration is of important value in the pathological study of severe infection, the informations of illness changes and the appropriate therapy selection.