多种损伤因子与重症胸腹损伤急性肝功能障碍相关性研究

目的探讨肿瘤坏死因子-α（tumornecrosisfactor-α，TNF-α）、白细胞介素-6（interleukin-6，IL-6）、磷脂酶A2（phospholipaseAz，PLA2）在重症胸腹损伤急性肝功能损害发生过程中的作用。方法胸腹创伤患者82例（观察组），同期体检健康者46例（对照组），检测2组谷丙转氨酶（glutamicpropylictransaminase，GPT）、谷草转氨酶（glutamicoxaolacetictransaminase，GOT）、TNF—α、IL-6和PLA2水平并进行比较。结果观察组就诊时GPT（（208．43±41．35）u／L）、GOT（（198．49±39．62）u／L）、TNF—α（（36．41±18．09）μg／L）、IL-6（（393．83±143．86）μg／L）、PLA2（（41．35±14．26）μg／L）均高于对照组（（17．25±4．48）u／L，（18．29±5．37）u／L，（1．28±0．59）μg／L，（63．93±41．49）μg／L，（7．47±5．27）μg／L）（P〈O．01）；观察组GPT、GOT分别与TNF-α、IL-6、PLA2呈显著正相关（P〈0．01）。结论TNF-α、IL-6、PLA2参与了胸腹损伤急性肝功能损害的发生、发展；对TNF—α、ID6、PLA2进行早期干预可抑制急性肝功能损害发生或减轻损害程度。

Correlation between multiple cytokine indexes and acute liver dysfunction after severe thoracoabdominal injury

Objective To investigate the correlation of tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） and phospholipase A2 （PLA2） with acute liver dysfunction in patients with severe thoracoahdominal injury. Methods A total of 82 patients with severe thoracoabdominal injury （observation group） and 46 health volunteers （control group） were detected glutamic propylic transaminase （GPT）, glutamic oxaolacetic transaminase （GOT）, TNF-α, IL-6 and PLA2. The correlation of the liver function with multiple cytokine indexes was analyzed. Results The levels of GPT, GOT, TNF-α, IL-6 and PLAz were significantly higher in observation group （（208.43±41.35） u/L, （198.49±39.62） u/L, （36.41± 18.09） μg/L, （393.83±143.86） μg/L and （41.35±14.26） μg/L） than those in control group （（17. 25±4.48） u/L, （18.29±5.37） u/L, （1.28±0.59） μg/L, （63.93±41.49）μg/Land （7.47±5.27） μg/L） （P〈0.01）. GPTandGOT were positively correlated with TNF-α, IL-6 and PLA2 in observation group （P%0.01）. Conclusions TNF-α, IL-6 and PLA2 all participate in the development and progression of acute liver injury after severe thoracoabdominal injury. Early intervening TNF-α, IL-6 and PLA2 can possibly prevent acute liver injury and relieve the injury degree in patients with severe thoracoabdominal injury.