【摘要】 目的　探讨细胞因子在全身炎症反应综合征 (SIRS)和多器官功能障碍综合征 (MODS)发生发展中的意义及其与SIRS/MODS严重程度的相关性 ,以初步探讨SIRS及MODS的发生机制 ,为临床防治提供理论依据。方法　选择我院儿童重症监护病室 (PICU)住院患儿 86例 ,用IMMULITE化学发光免疫分析仪分别测定入院 1、 3、 5d外周血肿瘤坏死因子 -a (TNF α)、白细胞介素 1 β (IL 1 β)和白细胞介素 6(IL 6 )。结果　TNF α、IL 1 β和IL 6在SIRS组、MODS组及死亡组均较非SIRS组、非MODS组及非死亡组明显升高 ,且SIRS组、MODS组及死亡组TNF α、IL 1 β和IL 6始终维持在较高水平 ,组内比较 ,1、 3、 5d有逐渐升高趋势 ,TNF α、IL 1 β和IL 6与MODS及死亡有一定程度相关关系。 结论　TNF α、IL 1 β和IL 6可反映病情严重程度 ,其中TNF α是较敏感的指标 ,可为探讨细胞因子在SIRS/MODS发病机制中的作用提供依据 ,为SIRS/MODS的辅助诊断指标 ,并指导临床早期诊断、早期治疗更多还原

【Abstract】 Objective To obtain insight into the role of serum cytokines in SIRS/MODS,and its relationships with the severity of SIRS/MODS and to initially explore the pathogenesis of SIRS and MODS,providing theoretical basis for clinical prevention and treatment.Methods Eighty six patients admitted to PICU were studied.Blood samples of(TNF α,IL 1β,IL 6)on day 1,3 and 5 were assayed using IMMULITE chemiluminescent immunometric analyzer.Results TNF α,IL 1β,and IL 6 levels in SIRS group,MODS group and death group were consistently higher than those in non SIRS groups,non MODS group,and non death group( P <0 05).TNF α,IL 1β,and IL 6 in SIRS group,MODS group,and death group each had a continuously increasing tendency at day 1,3 and 5.The level of TNF α,IL 1β,and IL 6 appeared to be correlated with morbidity of MODS and death.Conclusion TNF α,IL 1β,and IL 6 can reflect the severity of the illness.Among them,TNF α is a more sensitive index,provides basis for exploring the roles of cytokines in the development of SIRS/MODS,and can be the supplementary diagnostic criteria of SIRS/MODS.Understanding the roles of these cytokines in critically ill children with SIRS/MODS may lead to innovative therapeutic and preventive measures. [更多还原