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目的探讨在多器官功能衰竭综合征(MODS)患者中细胞因子TNF-α和血管内皮细胞功能标志物的变化。方法动态观察MODS及非MODS患者一氧化氮(NO)、内皮素(ET-1)、组织纤溶酶原激活物(t-Pa)、纤溶酶原激活物抑制物-1(PAI-1)、循环内皮细胞(CEC)、肿瘤坏死因子(TNF-α)的浓度,同时给予Marshall评分。结果与非MODS组相比,MODS组、死亡组的TNF-α、ET- 1、PAI-1、CEC、Marshall评分显著升高(P＜0．05),而NO、t-Pa显著降低(P＜0．05)。结论TNF-α作为炎性因子在MODS的进展中起重要作用；在MODS时内皮细胞的损伤表现为ET-1、PAI-1、CEC增加,NO、t-PA减少,Marshall评分对于危重症患者的评估是敏感指标。
Objective To investigate the changes of cytokine TNF-α and vascular endothelial cell function markers in patients with multiple organ failure syndrome (MODS). Methods The levels of nitric oxide (NO), endothelin (ET-1), tissue plasminogen activator (t-Pa), plasminogen activator inhibitor- ), Circulating endothelial cells (CEC), and tumor necrosis factor (TNF-α) were measured with Marshall score. Results The levels of TNF-α, ET-1, PAI-1, CEC and Marshall in MODS group and death group were significantly higher than those in non-MODS group (P <0.05) P <0.05). Conclusions TNF-α plays an important role in the progression of MODS as an inflammatory cytokine. The damage of endothelial cells in ET-1, PAI-1, CEC and NO, t-PA were observed in MODS. Marshall score was significantly higher in critically ill patients The assessment is a sensitive indicator.