ICU重症患者TNFα和CRP测定应用的探讨

目的通过定量测定ICU危重患者肿瘤坏死因子-α（TNF—α）和C-反应蛋白（CRP）的浓度，探讨两者的临床意义。方法将100例危重患者，根据APACHEⅡ评分系统分为A组（〈15分）25例，B组（15～25分）55例，C组（〉25分）20例，按病情分为MODS组38例，非MODS组62例。正常对照组为体检健康者50例。采集每组患者血标本，采用酶联免疫吸附法（ELISA）检测标本TNF—α、cTnI和CRP浓度。结果危重患者的TNF—α和CRP浓度均高于健康体检组（P〈0．01）；不同APACHEⅡ评分组之间TNF-α和CRP差异有统计学意义（P〈0．05或0．01）；MODS组患者的TNF-α和CRP值明显高于非MODS组（P〈0．01）。结论危重患者TNF-α、CRP和A—PACHEⅡ评分有较好的相关性，病情越重，两者的值越高。因此，可用于评价危重患者病情严重程度，对于预测预后有一定的临床意义。

The discussion of ICU patients with TNFot and CRP levels

Objective To explore the clinical significances of tumor necrosis factor -α （TNF -α） and C -reactive protein （CRP） of critically ill patients in ICU. Methods according to APACHE Ⅱ score system, 100 critically ill patients were divided into A group： 〈 15 points of 25 cases, B group： 15 to 25 points of 55 cases, C group 〉 25 points of 20 cases ; all cases were divided into MODS group 38 cases, non - MODS group 62 cases. Fifty normal healthy subjects were control group. Results The results showed that critically ill patients with TNF -α and CRP concentrations were higher than healthy people group （P 〈 0. 01 ）, TNF -α and CRP concentrations were significantly different （ P 〈 0. 05 or 0. 01 ） among different groups with APACHE Ⅱ scores; TNF -α and CRP of MODS group were significantly higher than non - MODS groups＇ （ P 〈 0. 01 ）. Conclusion Critically ill patients with TNF -α and CRP have good correlation with APACHE Ⅱ score, the more serious, the higher concentrations of the TNF -α and CRP. Therefore, TNF-α and CRP can be used to evaluate the severity of critically ill patients, also to predict prognosis of clinical patients.