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目的探讨多发伤患者外周血中细胞因子变化及其临床意义。方法采用ELISA法检测39例多发伤患者(创伤严重度>16)入院时,入院后1、3、5、7d,CRP、TNF-α、IL-6、IL-8水平变化(重伤组),并与同期创伤程度较轻(创伤严重度<16)的48例进行动态比较(轻伤后)。结果重伤组入院后CRP、TNF-α、IL-6、IL-8均显著升高,重伤组患者血清CRP释放高峰在入院后1d,其余三种炎性介质释放高峰期均在入院后3～5d;重伤组入院后24hIL-6水平与患者创伤严重度评分呈正相关关系(r=0.83,P<0.05);重伤组10例发生多器官功能障碍综合征(MODS)和轻伤组相比,IL-6、IL-8在入院后1、3、5、7d升高具有统计学差异,而TNF-α只有在入院时、入院后1d才具有显著性差异性,CRP在两组之间没有差异性。结论创伤引起的炎性介质的大量释放在多发伤患者的病情发展中起着重要作用,及时检测患者体内炎性因子的变化,可以更好的观察患者的治疗效果,准确的预测患者的病情发展。
Objective To investigate the changes of cytokines in peripheral blood of patients with multiple trauma and its clinical significance. Methods The levels of CRP, TNF-α, IL-6 and IL-8 in 39 cases of multiple traumatic injury (severity of trauma> 16) were detected by ELISA at 1,3,5,7 days after admission. And 48 patients with lesser trauma (traumatic severity <16) during the same period were compared dynamically (after minor trauma). Results The levels of CRP, TNF-α, IL-6 and IL-8 in severe injury group were significantly higher than those in severe injury group. The peak of CRP release in severely injured group was at 1 day after admission and the peak of other three inflammatory mediators was 3 ~ There was a positive correlation between IL-6 level and the severity of trauma patients (r = 0.83, P <0.05) after admission. The incidence of multiple organ dysfunction syndrome (MODS) in severe injury group was significantly higher than that of mild injury group The levels of IL-6 and IL-8 increased statistically at 1, 3, 5 and 7 days after admission, while TNF-α was only significant at 1 day after admission, and there was no difference between the two groups difference. Conclusion The massive release of inflammatory mediators induced by trauma plays an important role in the progression of the disease in multiple trauma patients. The timely detection of inflammatory cytokines in patients can better observe the therapeutic effect of the patients and accurately predict the progression of the patients’ condition .