百草枯中毒患者血清细胞因子的变化及其与脏器损害、预后关系的研究

目的 通过检测百草枯中毒(PQP)患者血清IL-6,TNF-α水平及心肌酶、肝、肾功能,研究炎症介质在PQP发生中的机制、对心脏、肝脏、肾脏的损伤及IL-6,TNF-α水平与病情严重程度及与预后的关系,为临床诊治PQP、判断疾病的预后提供理论依据.方法 收集我院急诊科2006年1月～2011年12月PQP患者62例,所有入选对象查肝、肾功能、心肌酶、IL-6、TNF α,采用APACHEⅡ对患者进行病情严重程度的评分.多组间比较采用单因素方差分析,血清IL-6,TNF-α与APACHEⅡ评分采用Spearman相关.检验水准取α=0.05.结果 PQP患者血清IL-6、TNF-α水平高于正常对照组,死亡组高于存活组、对照组;病例组血清心肌酶测定值,谷丙转氨酶、谷草转氨酶值,尿素氮、肌酐值高于正常对照组,差异具有统计学意义.血清TNF-α和IL-6水平与APACHEII评分经Spearman相关分析呈正相关.结论 炎症因子TNF-α和IL-6参与了百革枯中毒的发病过程,并与病情严重程度及预后有一定的相关性;可以作为反映病情严重程度的参考指标.

Study on the Changes of serum cytokines in PQP patients and organ damage, its relationship with prognosis

Objective By detecting the levels of IL-6, TNF-ct and myocardial enzymes in the serum, liver and kidney function in paraquat poisoning （PQP） patients, We study the mechanism of inflammatory mediators in the PQP,injury in heart, liver, kidneys and its relation with prognosis, it can provide the theoretical basis for clinical diagnosis and treatment ,judging prognosis of the disease. Methods We collected 62 cases From January 2006 to December 2011, checked liver and kidney function, myocardial enzymes, IL-6, TNF-a. APACHE II was used to explained the severity of illness. ANOVA was used to deal with repeated measured data. Spearman correlation analysis was used to measure the correlation between IL-6,TNF-a and APACHE II scoring, p〈0.05 was considered statistically significant. Results The levels of IL-6, TNF-a in PQP patients was significantly higher than that in the control group, the difference was statistically significant. Spearman correlation analysis show that The levels of IL-6, TNF-a in PQP patients was positively correlated with APACHE II scoring. Conclusion The inflammation factor TNF-a and IL-6 participated in the paraquat poison morbidity process, and can certain relevance with the condition serious degree and the prognosis.