血清C-反应蛋白、白细胞介素6和肿瘤坏死因子α在肠梗阻、肠穿孔患者的动态观测及临床意义

The dynamic observation and clinical significance of interleukin-6,tumor necrosis factor-αand c-reactive protein in patients with intestinal obstruction and intestinal perforation

目的 探讨肠梗阻和肠穿孔患者血清中C 反应蛋白 (CRP) ,白细胞介素 6 (IL 6 )和肿瘤坏死因子α(TNF α)含量的动态变化并评价其临床意义。方法 检测 38例肠梗阻患者 (肠梗阻组 )和 36例肠穿孔患者 (肠穿孔组 )入院当日、入院后第 1,3 ,5 ,7d的血清CRP ,IL 6和TNF α含量。结果 肠梗阻及肠穿孔患者血清IL 6 ,TNF α在症状发生 2 4h内即升高 ,持续 1周以上 ,二者变化呈正相关。肠梗阻患者血清CRP在症状发生 2 4h后升高 ,而肠穿孔患者CRP在症状发生 2 4h内即明显升高。结论 肠梗阻及肠穿孔患者血清IL 6 ,TNF α升高 ,二者变化一致 ;但肠梗阻患者CRP升高要延迟于肠穿孔患者 。

Objective To investigate the clinical value of the dynamic changes of the level of IL 6, TNF α and C ractive protein(CRP) in patients with intestinal obstruction and intestinal perforation. Methods Serum level of IL 6, TNF α, CRP were detected both in 38 patients with intestinal obstruction and 36 intestinal perforation on admission day and 1, 3, 5, 7 day after admission. Results The level of IL 6, TNF α was signficantly higher in patients with intestinal obstruction and intestinal perforation within 24 hours after synptoms present than that in healthy people(P<0.05), and with strong positive correlation between the levels of IL 6 and TNF α. The rise time of CRP was earlier in intestinal perforation patients(within 24 hours after synptoms present) than that in intestinal obstruction patients(>48?h after synptoms present). Conclusions The level of IL 6, TNF α, CRP rise dramatically in patients with intestinal perforation and in testinal obstruction. CRP may be a more useful and sensitive marker in distinguishing the patient with intestinal perforation and with intestinal obstruction.