肺挫伤后TNF、IL-8的动态变化及其临床意义

目的　探讨血清炎性细胞因子的肿瘤坏死因子 (TNF)和白细胞介素 8(IL -8)在肺挫伤及其继发性肺损伤中的作用。方法　严格选择 3 6例肺挫伤患者 ,用ELISA法测定TNF、IL -8血清浓度的动态变化 ;合并少量血胸者同时测定胸液中的TNF、IL -8水平 ;继发急性呼吸窘迫综合征 (ARDS)者亦动态观察各项指标的变化。同期选择单纯肋骨骨折及正常人为对照组。结果　肺挫伤和肺损伤后继发ARDS患者血清中的TNF、IL -8水平明显升高 ;肺挫伤后胸腔积液中的TNF、IL -8变化极为显著 ,P均 <0 .0 1。结论　TNF、IL -8在肺挫伤及其继发性肺损伤中起着重要作用 ;对肺挫伤合并少量血胸患者 ,应注意其胸液TNF、IL -8浓度的监测 ,可更敏感地观察肺挫伤的治疗效果、预测肺损伤的演变

The Dynamic Variations of Clinical Implications of TNF AND IL-8 in Patients with Lung Contusion

Objective To probe into actions of TNF (tumor necrosis factors) of sera inflammatory cell factors and Interleukin-8 (IL-8) in patients with lung contusion and secondary lung injury. Methods The dynamic variations of sera pH indicators of TNF and IL-8 were tested through ELISA method in36 strictly chosen patients with lung contusion, the TNF and IL-8 levels of a few patients with haemothorax were also tested simultaneously; dynamic observations on changes of various indicators in patients with secondary acute respiratory distress syndrome (ARDS) were conducted as well with simple fracture of ribs and healthy persons as the control groups. Results There were significant increases in the TNF and IL-8 levels of sera in patients with lung contusion and lung injury with secondary ARDS. Changes of TNF and IL-8 in patients with pleural effusion caused by lung contusion with an average P<0.01. Conclusion TNF and IL-8 played an important role in patients with lung contusion and secondary lung injury and TNF and IL-8 pH indicators of hydrothorax in patients with lung contusion with light haemothorax should be carefully monitored for more sensitive and better observations of treatment effects and predict the evolution of lung injury.