外周穿刺中心静脉置管术患者炎症细胞因子和凝血四项水平分析

Levels of inflammatory cytokines and 4 coagulation parameters of patients with PICC

目的:探讨外周穿刺中心静脉置管术(PICC)患者血清TNF-α、IL-6、IL-10及凝血四项水平的变化。方法:以未PICC患者38例为对照(包括肿瘤患者10例、非肿瘤患者18例和血液病患者10例),对比分析PICC患者(包括肿瘤患者14例、非肿瘤患者20例和血液病患者16例)炎症细胞因子TNF-α、IL-6、IL-10和凝血四项水平的变化。放射免疫法测定血浆TNF-α、IL-6水平,酶联免疫吸附试验测定IL-10,全自动血凝仪测定凝血四项。结果:PICC肿瘤、非肿瘤、血液病组TNF-α水平高于相应未PICC对照组(t分别为2.330、3.606和3.110,P均<0.05),IL-6水平低于相应对照组(t分别为7.120、5.863和2.572,P均<0.05),IL-10水平无明显变化(t分别为0.881、0.887和0.079,P均>0.05);非肿瘤PICC组凝血四项与未PICC对照组比较,差异均无统计学意义(P均>0.05)。结论:PICC置管后血浆TNF-α水平的升高和IL-6水平的下降可能与静脉血栓形成有关。

Aim：To investigate the the changes of the levels of TNF-α,IL-6,IL-10,and coagulation parameters in serum of peripherally inserted central catheter（PICC）patients.Methods：A total of 38 patients not performed PICC（including 10 patients with tumor,18 patients without tumor,and 10 patients with blood diseases）and 50 patients with PICC（including 14 patients with tumor,20 without tumor and 16 with blood diseases）,were collected and the levels of TNF-αand IL-6 in serum were determined by radioimmunoassay,the level of IL-10 by ELISA,and with the level of coagulation parameters by automatic coagulation machine.Results：Compared with the control groups,the levels of TNF-αof PICC patients with tumor,without tumor,and with blood diseases were higher（t=2.330,3.606,and 3.110,P0.05）,and the levels of IL-6 were lower（t=7.120,5.863,and 2.572,P0.05）,but the levels of IL-10 had no significant difference（t=0.881,0.887,and 0.079,P0.05）.The levels of coagulation parameters of non-tumor PICC group had not changed significantly （P0.05）.Conclusion：TNF-αbecomes more higher and IL-6 becomes more lower after PICC,suggesting PICC may lead to venous inflammation and then result in thrombosis.