严重烧伤病人血清TNF活性变化及其意义

本文采用生物法检测了24例严重烧伤病人血清TNF活性,同时观察了心、肝血清酶、血乳酸、血糖、血清蛋白以及WBC等的变化。结果提示伤后TNF大量产生,引起血管内皮细胞损害和变性,形成血栓致组织缺血缺氧,加上PMN释放增加,趋化聚集于受损脏器并活化产生大量毒性物质,损伤组织器官,导致OI甚至MOF的发生发展。TNF又通过内生性致热原和恶病质作用,使机体发热、糖元耗竭,肌肉蛋白分解及消耗增加等,降低机体防御功能,易于发生严重感染和恶病质状态,有助内脏功能损害的发生发展。

Significance of the changes of serum tumor necrosis facror activity in patients with severe burns

The dynamica changes of the activity of serum tumor necrosis factor(TNF)was determined in 24 patients with severe burns,and the changes of cardiac and hepatic enzymes,plasma lactate and glucose,serum protein,WBC count etc were determined as well.It was found that TNF was produced in large amounts to damage and degenerate the vascular endothe-lium.Consequently intravascular emboli were more liable to occur to result in tissue hypoxia.TNF could also induce the release of polymorphonuclear neutrophils(PMNs)from the bone marrow.PMNs by chemotacsis accumulated in the inflammatory tissues to produce large amounts of toxic products,which could damage the cells and tissues directly to result in multiple organ failure.Furthermore,TNF,through the mediation of pyrogen and cachectin,could induce febrile reaction,exhaustion of glycogen reserve,and increment of muscular protein catabolism.Eventually the energy consumption of the host would be incresed and his defensive function weakened.