急性失血患者血浆白细胞介素-6、白细胞介素-8、肿瘤坏死因子-α和一氧化氮合酶的变化探讨

Investigation of the changes of plasma interleukin-6, interleukin-8, tumor necrosis factor-alpha in acute blood loss patients

目的探讨急性失血患者血浆白细胞介素（IL）-6、IL-8、肿瘤坏死因子（TNF）-α和一氧化氮合酶（NOS）变化及其意义。方法入选25例急性失血患者（失血组）和25例健康体检者（对照组），采用酶联免疫吸附法检测两组血浆IL-6、IL-8、TNF—α和NOS水平。结果失血组血浆IL．6、IL-8、TNF—α和NOS水平明显高于对照组（0．284±0．027比0．204±0．016、0．059±0．079比0．037±0．039、0．460±0．024比0．372±0．018、0．637±0．054比0．443±0．040，P〈0．05或〈0．01）。结论急性锐器刺割伤致失血易引起血浆IL-6、IL-8、TNF-α和NOS水平升高，IL-6、IL-8、TNF-α释放加重组织器官损伤及失血性休克发展。NOS水平升高促进一氧化氮的合成增加，在急性失血血容量不足时促进微循环灌注，缓解组织灌注不足，可能对机体起保护作用。

Objective To investigate the changes and significance of plasma interleukin （IL）-6, IL-8, tumor necrosis factor-alpha （TNF-α ） and nitric oxide synthase （NOS） in acute blood loss patients. Methods The levels of plasma IL-6, IL-8, TNF-α and NOS were determined in 25 patients with acute blood loss（blood loss group） and 25 healthy controls（control group） by enzyme linked immunosorbent assay. Result The levels of plasma IL-6, IL-8, TNF- α and NOS in blood loss group were higher than those in control group （0.284 ±0.027 vs. 0.204 ±0.016, 0.059 ±0.079 vs. 0.037 ±0.039, 0.460 ±0.024 vs. 0.372 ± 0.018, 0.637 ~ 0.054 vs. 0.443 ± 0.040,P 〈 0.05 or 〈 0.01 ）. Conclusions First,the expressions of IL-6,IL-8,TNF-α and NOS are strongly induced at the circumstances of acute early stage blood loss which can cause inflammatory reaction, aggravate the damage of soft tissues and organs, and easy to lead the blood loss to uncontrolled hemorrhagic shock. Second, the expression of NOS is strongly induced at the circumstances of acute blood loss which should reduce the damage of soft tissue, and alleviate the hemorrhagic shock. Therefore, the levels of plasma IL-6, IL-8, TNF- α and NOS can estimate the illness prognosis and curative effect, which have important clinical instruction value for effective treatment of hemorrhagic shock.