创伤患者血清神经内分泌激素及细胞因子的变化研究

目的旨在探讨神经内分泌激素及细胞因子在创伤后的变化及其临床意义。方法 63例创伤患者根据ISS评分分为中重度两组,创伤后4 h内采血,分别测定患者血清肾上腺素(NE)、促肾上腺皮质激素(ACTH)、皮质醇及促炎因子肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)的水平。结果重度创伤患者在血清NE、ACTH、皮质醇及TNF-α和IL-6水平均较对照组显著升高(p<0.05);而且后三者水平在重度创伤者中显著高于中度创伤者(p<0.05)。结论从神经、内分泌、免疫三个系统入手,研究创伤应激的发生机制,并设法对其进行调控,将会对其治疗提供理论依据。

STUDY ON THE CHANGE OF CYTOKINES AND NEUROHORMONAL ACTIVATION IN THE SERUM OF TRAUMATIC PATIENTS

Objective To explore the change of Cytokines and Neurohormonal Activation in traumatic patients and their clinical significance. Methods According to the ISS Grade,63 traumatic patients were divided into two groups, one was moderate injury, and the other was severe. The control group was normal people. Their blood was taken within 4 hours after injury. The level of the epinephrine （ NE）, adrenocorticotrophic hormone （ ACTH ）, cortisol, inflammation factors such as tumor necrosis factor- α （TNF -α） and interleukin -6 （IL -6 ） were tested in the serum. Results The level of NE, ACTH, eortisol, TNF - α and IL - 6 in the traumatic patients serum were sig- nificantly higher than that in control group （p 〈 0. 05 ）. The level of cortisol, TNF - α and IL - 6 in severe traumatic patients was significantly higher than that in moderate one （p 〈 0. 05 ）. Conclusion Study the activating mechanism of traumatic stress reaction through nerve, endocrine and immunity system and try to adjust them, it will propose the theoretical bases of treatment.