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目的探讨血清磷脂酶Ａ２（ＰＬＡ２）及细胞因子在休克发生发展中的作用及意义。方法采用ＥＬＩＳＡ法检测１６例休克患儿及２０例健康儿童血清ＰＬＡ２、肿瘤坏死因子（ＴＮＦ－ａ）及白细胞介素（ＩＬ～６）含量，并作临床脏器功能监测、血乳酸、血糖、动脉血气分析及血小板计数。结果休克患儿血清ＰＬＡ２（０．８９±０．６３ｍｐ／Ｌ）、ＴＮＦ－ａ（０、６３±０．２５ｍｇ／Ｌ）及ＩＬ－６（６．８４±１９７ｍｇ／Ｌ）浓度均较正常对照组（０．１７±０．０２ｍｇ／Ｌ、０．０８±０．０１ｍｇ／Ｌ、２．３２±０．６２ｍｇ／Ｌ）明显升高（Ｐ＜０．００１）；多器官功能衰竭组（ＭＳＯＦ）上述３项指标（ＰＬＡ２１．１７±０．７０ｍｇ／Ｌ、ＴＮＦ－ａ０．９１±０．２７ｍｐ／Ｌ、ＩＬ－６７．７０±１．４０ｍｇ／Ｌ）均显著高于单器官功能衰竭组（ＳＯＦ）（ＰＬＡ２０．４８±０．０７ｍｇ／Ｌ、ＴＮＦ－ａ０．４７±０．０５ｍｇ／Ｌ、ＩＬ－６５．５５±０．７０ｍｇ／Ｌ），死亡组明显高于治愈组。结论ＰＬＡ２水平与病情轻重有关，可作为早期预测ＭＳＯＦ发生的参数、评估治疗效果及预后。选择性投用ＰＬＡ２抑制剂可能成为治疗休克的有效方法。
Objective To investigate the role and significance of serum phospholipase A2 (PLA2) and cytokines in the development of shock. Methods Serum levels of PLA2, TNF-a and IL-6 were measured by ELISA in 16 children with shock and 20 healthy children. The levels of serum PLA, blood glucose, Arterial blood gas analysis and platelet count. Results The serum levels of PLA2 (0.89 ± 0.63mp / L), TNF-α (0,63 ± 0.25mg / L) and IL-6 (6.84 ± 197mg / L) Group (0.17 ± 0.02mg / L, 0.08 ± 0.01mg / L, 2.32 ± 0.62mg / L) was significantly higher (P <0.001); multiple organ failure group (MSOF ) The above three indicators (PLA21.17 ± 0.70mg / L, TNF-a0.91 ± 0.27mp / L, IL-67.70 ± 1.40mg / L) were significantly higher than the single organ failure group SOF) (PLA20.48 ± 0.07mg / L, TNF-a0.47 ± 0.05mg / L, IL-65.55 ± 0.70mg / L), the death group was significantly higher than the cure group. Conclusions The level of PLA2 is related to the severity of the disease. It can be used as a parameter to predict the occurrence of MSOF in the early stage and to evaluate the therapeutic effect and prognosis. Selective administration of PLA2 inhibitors may be an effective method of treating shock.