【摘要】 目的　研究机械性创伤患者伤后血清白细胞介素 6 (IL - 6 )、肿瘤坏死因子α(TNF -α)的变化及其与创伤评分的关系 ,探讨其可能机制及临床意义。方法　选择机械性创伤患者 5 0例 ,按创伤评分标准分成 3组 ,轻度 31例 ,ISS≤ 16 ;重度 13例 ,16 <ISS <2 5 ;极重度 6例 ,ISS≥ 2 5。全部患者于伤后 2 4h内采血 ,其中 2 5例患者还于伤后 3、5、7、9、12d各采血 1次 ,采用ELISA法测定IL - 6、TNF -α血清含量。结果　血清IL - 6、TNF -α于创伤后 2 4h内明显高于正常值 (P <0 0 5 ) ,动态观察组患者呈波动性先升后降的变化 ,轻度患者高峰值早于重度、极重度患者 ,血清IL - 6的含量与创伤程度呈正相关 (r=0 336 ,P <0 0 2 )。结论　IL - 6可作为判别创伤严重程度的灵敏指标 ,TNF -α和IL - 6的变化反映机体于创伤后呈过度炎症反应。更多还原

【Abstract】 Objective To investigate the post-traumatic changes in the serum level of interleukin-6(IL-6) and tumor necrosis factor alpha(TNF-α) and their relationship with injury severity score(ISS) and to inquire into the possible mechanism and clinical significance.Methods Fifty patients with mechnical trauma were eligible and include.According to the standard of injury severity score(ISS),the patients were divided into three groups:mild degree group(ISS≤16,n=31),severe degree group (16<ISS<25,n=13) and extremely severe degree group(ISS≥25,n=6).The blood samples of all patients were obtained within 24 hours,and those of 25 dynamiclly observed patients were obtained on 3,5,7,9 and 12 days.The serum levels of IL-6 and TNF-α were asssyed by ELISA.Results The serum level of IL-6 and TNF-α were significantly higher in patients with trauma than in normal group within 24 hours( P <0 05) The dynamical observation showed that the two indexs demonstrated curve changes with increase in early stage and decrease later.The climax of them appeared earlier in mild group than those in severe and extremely severe groups.The level of IL-6 was correlative with the severity of trauma( r =0 336, P <0 02) Conclusions The level of IL-6 was sensitive indexes of the degree of trauma.The changes of IL-6,TNF-α reflected the exaggerated inflammmtory response in post-traumatic patients.更多还原