镇静治疗对危重烧伤患者炎症因子释放的影响

[目的]观察危重烧伤后镇静治疗对促炎/抑炎细胞因子平衡的影响.[方法]46例烧伤Ⅱ度以上,创面总面积＞30％患者随机分为两组,每组23例.对照组按常规补液复苏,观察组在对照组的基础上应用丙泊酚微量持续静脉镇静治疗.分别在镇静前（T0）、镇静后3 h（T1）、镇静后6 h（T2）、镇静后48 h（T3）抽血用ELISA方法检测患者血清中白介素-1（IL-1）、肿瘤坏死因子-α（TNF-α）、IL-10的含量.[结果]与伤前比较,严重烧伤后血清TNF-α、IL-1、IL-10均升高（P＜0.05）,镇静治疗可降低其升高幅度（P＜0.05）.[结论]应用镇静治疗可抑制大面积烧伤患者主要炎症介质的释放,调节促炎/抑炎细胞因子平衡,减轻应激,有利于机体功能的恢复.

Study on the Impact of Sedation Therapy on the Release of Inflammatory cytokines in Patients with Severe Burns

[Objective]To observe the effect of sedation therapy on the balance of pro/anti-inflammatory cytokines after severe burns.[Methods] A total of 46 patients with over Ⅱ degree burns and the total wound area more than 30％ were randomly divided into two groups with 23 patients in each group.The control group received conventional fluid resuscitation,while the observation group received propofol continuous intravenous injection for sedation therapy based on the treatment of control group.ELISA was used to determine serum levels of interleukin1 （IL-1）,tumor necrosis factor-alpha（TNF-α） and interleukin-10（IL-10） in patients before（T0）,3h（T1）,6h（T2） and 48h（T3） after sedation.[Results] Compared with before burns,serum levels of TNF-α,IL-1,IL-10 after severe burns were increased（P ＜0.05）.Sedation could reduce the increasing extent（P ＜0.05）.[Conclusion]Sedation can inhibit the release of major inflammatory mediators in patients with large area of burns,and regulate the balance of pro/anti-inflammatory cytokines,and reduce the stress as well as help the recovery of body function.