创伤患者外周血白细胞介素-18水平与多器官功能障碍综合征严重程度的相关分析

Dynamic change in interleukin-18 and its relationships with multiple organ dysfunction syndrome

目的 研究创伤患者白细胞介素 18(IL 18)血浆水平的变化规律 ,并评估 IL 18在创伤后脏器功能不全发生中的预警价值。方法 对从 2 0 0 1年 3月— 2 0 0 2年 9月收入院的 5 4例创伤患者进行回顾性研究 ,根据创伤严重程度 (ISS)评分把患者分成低 ISS(L ISS)和高 ISS(H ISS)两组 ,在入院 1、4、7和 14 d分别采集血标本 ,用酶联免疫吸附法 (EL ISA)测量 IL 18水平 ,根据病历对脏器功能不全的发生情况进行回顾性评价。结果 IL 18在创伤后出现明显的改变 ,在 4和 7d内达到峰值并在 14 d内逐渐下降 ,其改变与创伤严重程度有关。此外 ,发生脏器功能不全的患者血浆 IL 18水平相对较高。结论 IL 18可以作为一项创伤后脏器功能不全发生的敏感监测指标。

Objective To determine interleukin-18 (IL-18) in plasma after trauma, and evaluate its relationship with multiple organ dysfunction syndrome. Methods A total of 54 patients were enrolled and divided into low injury seriousness score (L-ISS) and high injury seriousness score(H-ISS) groups. Blood IL-18 levels were determined on admission, day 4, day 7 and day 14 after trauma using enzyme-linked immunoadsorbent assay(ELISA), and the relationship between its level and organ dysfunction was analyzed. Results Plasma IL-18 concentration was significantly increased on posttrauma day 4 and day 7. Also, plasma IL-18 concentration was significantly higher in patients with organ dysfunction. Conclusion This study suggests that major trauma can lead to a marked elevation of IL-18, which might be associated with organ dysfunction.