中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
35期
11-13
,共3页
李志伟%王著军%徐旭%郭雅琼%乔帅%梁永刚%马之嘉%王树龙%冀蒙
李誌偉%王著軍%徐旭%郭雅瓊%喬帥%樑永剛%馬之嘉%王樹龍%冀矇
리지위%왕저군%서욱%곽아경%교수%량영강%마지가%왕수룡%기몽
肝功能不全%肿瘤坏死因子α%内毒素类%白细胞介素6%磷脂酶A
肝功能不全%腫瘤壞死因子α%內毒素類%白細胞介素6%燐脂酶A
간공능불전%종류배사인자α%내독소류%백세포개소6%린지매A
Hepatic insufficiency%Tumor necrosis factor-alpha%Endotoxins%Interleukin-6%Phospholipase A
目的 探讨肿瘤坏死因子(TNF)-α、内毒素、白细胞介素(IL)-6、磷脂酶A2(PLA2)在重症胸腹损伤急性肝功能障碍发生过程中的作用.方法 收集创伤指数≥17分、除外合并颅脑损伤及在急诊死亡的胸腹损伤患者82例(损伤组),在救治同时抽血检查丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、TNF-α、内毒素、IL-6和PLA2,并与36例健康体检者(对照组)进行比较.采用线性相关进行相关性分析.结果 损伤组ALT、AST、TNF-α、内毒素、IL-6、PLA2均明显高于对照组[(208.43±41.35) U/L 比(17.25±4.48) U/L、(198.49±39.62) U/L比(18.29±5.37) U/L、(36.41±18.09) μg/L比(1.28±0.59) μg/L、(343.66±106.02) U/L比(87.38±46.51) U/L、(393.83±143.86)μg/L比(63.93±41.49)μg/L、(41.35±14.26)μg/L比(7.47±5.27) μg/L],差异有统计学意义(P＜0.01).重症胸腹损伤患者ALT和AST与TNF-α、内毒素、IL-6、PLA2均呈正相关(r=0.9423和0.9643、0.8657和0.8860、0.9514和0.9326、0.9142和0.9618,P＜0.01).结论 TNF-α、内毒素、IL-6、PLA2均参与了重症胸腹损伤后急性肝功能障碍的发生、发展.急诊救治重症胸腹损伤患者时,应对TNF-α、内毒素、IL-6、PLA2进行早期干预,或有可能抑制急性肝功能障碍的发生或减轻其严重程度.
目的 探討腫瘤壞死因子(TNF)-α、內毒素、白細胞介素(IL)-6、燐脂酶A2(PLA2)在重癥胸腹損傷急性肝功能障礙髮生過程中的作用.方法 收集創傷指數≥17分、除外閤併顱腦損傷及在急診死亡的胸腹損傷患者82例(損傷組),在救治同時抽血檢查丙氨痠氨基轉移酶(ALT)、天鼕氨痠氨基轉移酶(AST)、TNF-α、內毒素、IL-6和PLA2,併與36例健康體檢者(對照組)進行比較.採用線性相關進行相關性分析.結果 損傷組ALT、AST、TNF-α、內毒素、IL-6、PLA2均明顯高于對照組[(208.43±41.35) U/L 比(17.25±4.48) U/L、(198.49±39.62) U/L比(18.29±5.37) U/L、(36.41±18.09) μg/L比(1.28±0.59) μg/L、(343.66±106.02) U/L比(87.38±46.51) U/L、(393.83±143.86)μg/L比(63.93±41.49)μg/L、(41.35±14.26)μg/L比(7.47±5.27) μg/L],差異有統計學意義(P＜0.01).重癥胸腹損傷患者ALT和AST與TNF-α、內毒素、IL-6、PLA2均呈正相關(r=0.9423和0.9643、0.8657和0.8860、0.9514和0.9326、0.9142和0.9618,P＜0.01).結論 TNF-α、內毒素、IL-6、PLA2均參與瞭重癥胸腹損傷後急性肝功能障礙的髮生、髮展.急診救治重癥胸腹損傷患者時,應對TNF-α、內毒素、IL-6、PLA2進行早期榦預,或有可能抑製急性肝功能障礙的髮生或減輕其嚴重程度.
목적 탐토종류배사인자(TNF)-α、내독소、백세포개소(IL)-6、린지매A2(PLA2)재중증흉복손상급성간공능장애발생과정중적작용.방법 수집창상지수≥17분、제외합병로뇌손상급재급진사망적흉복손상환자82례(손상조),재구치동시추혈검사병안산안기전이매(ALT)、천동안산안기전이매(AST)、TNF-α、내독소、IL-6화PLA2,병여36례건강체검자(대조조)진행비교.채용선성상관진행상관성분석.결과 손상조ALT、AST、TNF-α、내독소、IL-6、PLA2균명현고우대조조[(208.43±41.35) U/L 비(17.25±4.48) U/L、(198.49±39.62) U/L비(18.29±5.37) U/L、(36.41±18.09) μg/L비(1.28±0.59) μg/L、(343.66±106.02) U/L비(87.38±46.51) U/L、(393.83±143.86)μg/L비(63.93±41.49)μg/L、(41.35±14.26)μg/L비(7.47±5.27) μg/L],차이유통계학의의(P＜0.01).중증흉복손상환자ALT화AST여TNF-α、내독소、IL-6、PLA2균정정상관(r=0.9423화0.9643、0.8657화0.8860、0.9514화0.9326、0.9142화0.9618,P＜0.01).결론 TNF-α、내독소、IL-6、PLA2균삼여료중증흉복손상후급성간공능장애적발생、발전.급진구치중증흉복손상환자시,응대TNF-α、내독소、IL-6、PLA2진행조기간예,혹유가능억제급성간공능장애적발생혹감경기엄중정도.
Objective To investigate the effectiveness of tumor necrosis factor (TNF)-α,endotoxin,interleukin (IL)-6,phospholipase A2 (PLA2) in acute liver function disorders after severe chest-abdominal injury.Methods Eighty-two patients with severe chest-abdominal injury were collected as injury group,trauma index were all above or equal to 17 scores,and the patients who were complicated with craniocerebral injury and died in the emergency room were excepted.Alanine aminotransferase (ALT),aspartate aminotransferase (AST),TNF-α,endotoxin,IL-6 and PLA2 were examined in the rescue at the same time.These indicators were compared with 36 healthy examination subjects (control group).Correlation was analyzed by linear correlation.Results ALT,AST,TNF-α,endotoxin,IL-6,PLA2 in injury group were significantly higher than those in control group [(208.43 ± 41.35) U/L vs.(17.25 ± 4.48) U/L,(198.49 ±39.62) U/L vs.(18.29 ± 5.37) U/L,(36.41 ± 18.09) μ g/L vs.(1.28 ± 0.59) μ g/L,(343.66 ± 106.02) U/L vs.(87.38 ± 46.51) U/L,(393.83 ± 143.86) μ g/L vs.(63.93 ± 41.49) μ g/L,(41.35 ± 14.26) μ g/L vs.(7.47 ± 5.27) μμ g/L],there were statistical differences (P ＜ 0.01).There were positive correlation in severe chest-abdominal injury patients between ALT,AST and TNF-α,endotoxin,IL-6,PLA2 (r =0.9423 and 0.9643,0.8657 and 0.8860,0.9514 and 0.9326,0.9142 and 0.9618,P ＜0.01).Conclusions TNF-α,endotoxin,IL-6 and PLA2 all participate in the process of the acute liver function disorders in severe chestabdominal injury.The prophase interference in TNF-α,endotoxin,IL-6,PLA2 is possible to improve the liver function disorders in severe chest-abdominal injury.
