创伤后多器官功能不全综合征抗炎症反应和免疫抑制

目的：研究创伤后多器官功能不全综合征的抗炎症反应和免疫功能状况。方法 用ELISA法测定了33例创伤患者血浆IL－40、10、12、13水平。结果（1）所有患者不论是否出现SIRS、器官衰竭、血浆中均未测出IL－4。（2）血浆IL－10水平随器官衰竭数目的增加而升高（P＜0．05）;SIRS组、死亡组IL－10水平较非SIRS组、存活组明显升高（P＜0．01）。（3）SIRS组血浆IL－12水平较正常且和无SIRS组高（P＜0．05）。存活组血浆IL－12水平较死亡组高,提示血浆IL－12水平升高的创伤患者预后较好。（4）SIRS组、死亡组血浆IL－13水平与非SIRS组、存活组比较无明显差异,但较正常组升高（P＜0．05）。结论 创伤后多器官功能不全综合征抗炎症反应占主导,免疫抑制的患者预后多不良。

Studies on anti-inflammatory response and immun osupression in posttraumatic patients with multiple organ dysfunction syndrome

Objective　Thirty-three traumatic patients［m ean injury severity score （ISS）21.8±5.8, 18 cases ISS 18-25,15 cases ISS≥25 ］with MODS were involved in this research to testify their parameters of CARS a nd immunity.Methods　ELISA was utilized to detect plasma inter leukin(IL)-4,10,12,13.Results　(1)IL-4 was negatively measu red in all patients whether SIRS, organ failure existed or not.(2) With the in crease of number of organ failure, level of IL-10 was elevated (P <0.05). IL-10 of SIRS and dead groups was very significantly increase d than that of non-SIRS group and the survival group.(3)High IL-12 concentrat ion was found in the survival group than that in the dead group (P＜0.05).(4)No significant difference of IL-13 was discovered bet ween SIRS and non-SIRS groups,but higher than the control group(P ＜0.05). Conclusion　Posttraumatic patients with elev ated plasma IL-10 and low plasma IL-12 may be suscep tible to MODS with high mortality.