急性百草枯中毒后MODS患者血清TNF-α和IL-10的变化及意义

目的探讨急性百草枯中毒（APP）后多器官功能障碍综合征（MODS）患者血清TNF-α、IL-10的变化及临床意义。方法应用放射免疫技术测定32例APP后MODS患者与30名健康人血清TNF-α、IL-10水平,分析APP后MODS患者血清TNF-α、IL-10水平和急性生理学与慢性健康状况Ⅱ（APACHEⅡ）评分、动脉血氧分压（PaO2）、血尿素氮（BUN）、血肌酐（Scr）等指标的关系。结果APP后MODS患者血清TNF-α、IL-10水平较正常对照组明显升高（P〈0.05）,但死亡组与存活组比较差异无统计学意义（P〉0.05）;血清TNF-α、IL-10水平与APACHEⅡ评分、BUN、Scr呈正相关（P〈0.05）,与Pa02呈显著负相关（P〈0.01）。结论TNF-α、IL-10参与了APP后MODS的发病过程,且与APACHEⅡ评分呈正相关;血清TNF-α、IL-10水平可作为APP后MODS患者多器官功能损害程度评估与预后判断的临床指标之一。

The changes and clinical significance of plasma TNF-α and IL-10 in patients with multiple organ dysfunction syndrome caused by acute paraquat poisoning

Objective To study the changes and clinical significance of plasma tumor necrosis factor-α（TNF-α） and IL-10 in the patients with multiple organ dysfunction syndrome（MODS） caused by acute paraquat poisoning（APP）.Methods The levels of plasma TNF-α and IL-10 were measured by radioimmunoassay in 32 patients with MODS caused by APP and 30 healthy persons as controls.The levels of plasma TNF-α and IL-10 in the patients with MODS caused by APP were correlatively analysed with acute physiology and chronic health evaluationⅡ（APACHE Ⅱ）score,partial pressure of oxygen in artery（PaO2）,blood urea nitrogen（BUN）and serum creatinine（Scr）.Results The levels of plasma TNF-α and IL-10 in the patients with MODS caused by APP were much higher than controls（P〈0.05）,but there were no significant between death group and survivor group（P〉0.05）.The levels of plasma TNF-α and IL-10 in the patients with MODS caused by APP were positively correlated with APACHE Ⅱ score,BUN and Scr（P〈0.05 or P〈0.01）,and a negative correlation
with PaO2（P〈0.01）.Conclusion TNF-α and IL10 may be involved in the pathogenesis of MODS caused by APP,TNF-α and IL-10 may be one of a clinical index for evaluating the degree of multiple organ function damage and judging the prognosis of MODS caused by APP.