中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2011年
7期
746-748
,共3页
吴孟章%欧阳荡玉%黄芳%熊光仲
吳孟章%歐暘盪玉%黃芳%熊光仲
오맹장%구양탕옥%황방%웅광중
急性有机磷农药中毒%白细胞介素-10%肿瘤坏死因子-α%多器官功能障碍综合征
急性有機燐農藥中毒%白細胞介素-10%腫瘤壞死因子-α%多器官功能障礙綜閤徵
급성유궤린농약중독%백세포개소-10%종류배사인자-α%다기관공능장애종합정
Acute organophosphorus pesticide poisoning (AOPP)%Interieukin-10%Tumor necrosis factor-α%Multiple organ dysfunction syndrome
目的 探讨急性有机磷中毒患者早期血清中白细胞介素(IL)-10和肿瘤坏死因子(TNF)-α的表达及意义.方法 收集岳阳市二人民医院急诊科收治既往健康的急性有机磷农药中毒患者186例,按急性中毒诊断分级将186例患者分为轻度组、中度组和重度组.收集30例健康体检者作对照组.入院对患者进行APACHEⅡ评分,抽静脉血,用酶联免疫法测定血清中IL-10和TNF-α浓度.结果 中毒患者随病情加重而APACHEⅡ评分升高,差异均具有统计学意义(P＜0.05).中毒患者血清中IL-10浓度略高于对照组,差异无统计学意义(P＞0.05).对照组、轻度组、中度组和重度组患者血清中TNF-α依次升高,组间比较差异均有统计学意义.IL-10与APACHEⅡ评分无相关性,TNF-α与APACHEⅡ评分呈正相关性,TNF-α/IL-10比值与APACHEⅡ评分呈高度正相关性(P＜0.01).结论 急性有机磷中毒患者机体同时存在促炎反应和抗炎反应,炎症促进因子过度释放及炎症促进因子与炎症抑制因子平衡失调与急性有机磷中毒病情程度有关,是急性有机磷中毒引发多器官功能障碍综合征的重要机制之一.
目的 探討急性有機燐中毒患者早期血清中白細胞介素(IL)-10和腫瘤壞死因子(TNF)-α的錶達及意義.方法 收集嶽暘市二人民醫院急診科收治既往健康的急性有機燐農藥中毒患者186例,按急性中毒診斷分級將186例患者分為輕度組、中度組和重度組.收集30例健康體檢者作對照組.入院對患者進行APACHEⅡ評分,抽靜脈血,用酶聯免疫法測定血清中IL-10和TNF-α濃度.結果 中毒患者隨病情加重而APACHEⅡ評分升高,差異均具有統計學意義(P＜0.05).中毒患者血清中IL-10濃度略高于對照組,差異無統計學意義(P＞0.05).對照組、輕度組、中度組和重度組患者血清中TNF-α依次升高,組間比較差異均有統計學意義.IL-10與APACHEⅡ評分無相關性,TNF-α與APACHEⅡ評分呈正相關性,TNF-α/IL-10比值與APACHEⅡ評分呈高度正相關性(P＜0.01).結論 急性有機燐中毒患者機體同時存在促炎反應和抗炎反應,炎癥促進因子過度釋放及炎癥促進因子與炎癥抑製因子平衡失調與急性有機燐中毒病情程度有關,是急性有機燐中毒引髮多器官功能障礙綜閤徵的重要機製之一.
목적 탐토급성유궤린중독환자조기혈청중백세포개소(IL)-10화종류배사인자(TNF)-α적표체급의의.방법 수집악양시이인민의원급진과수치기왕건강적급성유궤린농약중독환자186례,안급성중독진단분급장186례환자분위경도조、중도조화중도조.수집30례건강체검자작대조조.입원대환자진행APACHEⅡ평분,추정맥혈,용매련면역법측정혈청중IL-10화TNF-α농도.결과 중독환자수병정가중이APACHEⅡ평분승고,차이균구유통계학의의(P＜0.05).중독환자혈청중IL-10농도략고우대조조,차이무통계학의의(P＞0.05).대조조、경도조、중도조화중도조환자혈청중TNF-α의차승고,조간비교차이균유통계학의의.IL-10여APACHEⅡ평분무상관성,TNF-α여APACHEⅡ평분정정상관성,TNF-α/IL-10비치여APACHEⅡ평분정고도정상관성(P＜0.01).결론 급성유궤린중독환자궤체동시존재촉염반응화항염반응,염증촉진인자과도석방급염증촉진인자여염증억제인자평형실조여급성유궤린중독병정정도유관,시급성유궤린중독인발다기관공능장애종합정적중요궤제지일.
Objective To investigate the expression and clinical significance of early-stage serum interieukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) in patients with acute organophosphorus pesticide poisoning (AOPP). Method 186 cases of AOPP were divided into mild group, moderate group and severe group according to the severity. 30 healthy volunteers served as control group. APACHE Ⅱ scores were evaluated for these patiences and their serum concentrations of IL-10 and TNF-α were detected by enzyme-linked immunosorbent assay (ELISA). Results APACHE Ⅱ scores increased significantly with the exacerbations of AOPP (P ＜0. 05). The serum IL-10 concentrations of AOPP was slightly higher than the control group. There was no significant difference compared with the control group (P ＞0. 05). APACHE Ⅱ scores positively correlated with the serum TNF-α concentrations, but not with the serum IL-10. However,the ratio of TNF-α and IL-10 positively correlated with APACHE Ⅱ scores ( P ＜ 0. 01 ). Conclusions There were pro-inflammatory response and anti-inflammatory response in patients with AOPP. Overrelease of inflammation promoting factor and imbalance between inflammation promoting and inhibiting factors correlated with the severity of AOPP, which may be an important mechanism of multiple organ dysfunction syndrome of AOPP.
