【摘要】 目的通过测定中重烧伤合并脓毒血症患者组织因子途径抑制物(TFPI)、组织因子(TF)和肿瘤坏死因子-α(TNF-α)的水平,了解TFPI、TF、TNF-α与感染及其严重程度的关系。方法选取中重度烧伤合并脓毒血症患者30例(烧伤组),按病程的前后分为:感染前期组(烧伤后72 h～7 d内);感染后期组(感染后期组,烧伤后10～14 d)。选取同期健康献血员20例(对照组)。用酶联免疫吸附法测定各组TFPI、TF、TNF-α水平。结果与对照组比较,感染前期组TFPI、TF及TNF-α抗原含量明显升高(P<0.01);感染后期组TF、TNF-α明显升高(P<0.01),但TFPI抗原含量无统计学意义(P>0.05)。与感染前期组比较,感染后期组TFPI抗原含量明显减低(P<0.05)。感染前期组TFPI与TF、TNF-α呈正相关(r=0.763、r=0.835,P<0.05);感染后期组TFPI与TF、TNF-α呈负相关(r=-0.873、r=-0.363,P<0.05)。结论中重度烧伤合并脓毒血症患者血浆中TF/TFPI的不断升高及TFPI/TNF-α的持续下降可以作为脓毒血症病情变化的监测指标。更多还原

【Abstract】 Objective To investigate the relationships of tissue factor pathway inhibitor(TFPI),tissue factor(TF) and tumor necrosis factor-α(TNF-α) to the infection and its degree.Methods Thi-rty patients with moderate and severe burn injuries and intercurrent sepsis were divided into early stages of infection group(3-7 days after burn) and late stages of infection group(10-14 days after burn).In addition,20 healthy blood donors were selected as control group.The levels of TFPI,TF and TNF-α were detected by using ELISA assay.Results Compared with control group,antigenic content of TFPI,TF and TNF-α significantly increased in early stages of infection group(P<0.01).TF and TNF-α significantly increased(P<0.01),no signifi-cant differences in antigenic content of TFPI were found between control group and late stages of infec-tion group(P>0.05).Compared with early stages of infection group,antigenic content of TFPI obviously decreased in late stages of infection group(P<0.05).The TFPI was positively correlated with TF and TNF-α in early stages of infection group(r=0.763、r=0.835,P<0.05),but negatively correlated with TF and TNF-α in late stages of infection group(r=-0.873、r=-0.363,P<0.05).Conclusion The increase in plasma TF/TFPI levels and the decrease in plasma TFPI/TNF-α levels can be used as the monitoring indicators for judging the changes in condition in patients with moderate and severe burn injuries and intercurrent sepsis.更多还原