严重创伤患者血浆细胞因子变化及其与器官功能损害的关系

作者通过观察１７例严重创伤患者血浆肿瘤坏死因子（ＴＮＦ）、白介素－６（ＩＬ－６）和白介素－８（ＩＬ－８）水平的变化及其与内脏功能损害和内毒素血症的关系,旨在阐明细胞因子在创伤后器官功能损害中的作用及其产生机制。结果显示,严重创伤后患者血浆细胞因子水平可相继明显升高,其中ＴＮＦ升高较早,其变化分别与伤情记分（ＩＳＳ）、心肝酶谱、肾功能指标以及血浆内毒素水平呈显著正相关。提示ＴＮＦ、ＩＬ－６和ＩＬ－８参与了严重创伤后器官功能损害的发生发展过程,创伤后细胞因子释放与创伤早期内毒素大量侵入体内有一定关系。

Changes of plasma cytokines in patients with severe trauma and their relationship with organ damage

We investigated kinetics of plasma TNF, IL 6 and IL 8 and their relationship with organ dysfunction and endotoxemia in 17 patients with severe trauma in order to further elucidate the role of cytokines in the development of organ damage and their production mechanism after trauma. Plasma cytokine levels significantly increased in trauma patients, and their plasma TNF was increased earlier. The cytokines were positively correlated with ISS, cardiac and hepatic enzyme activities, index of renal function, and plasma endotoxin levels. It is suggested that TNF, IL 6 and IL 8 may participate in the development of organ damage after trauma,and its release might be related to massive endotoxin translocation into body at the early stage of trauma.