现代诊断与治疗
現代診斷與治療
현대진단여치료
MODERN DIAGNOSIS AND TREATMENT
2014年
4期
763-765
,共3页
创伤%炎症因子%TNF-a%IL-1%IL-6
創傷%炎癥因子%TNF-a%IL-1%IL-6
창상%염증인자%TNF-a%IL-1%IL-6
Trauma%Inflammation Cytokines%TNF￣a%IL￣1%IL￣6
创伤是各种致伤因素造成的人体组织损伤和功能障碍，严重创伤导致全身炎症反应综合征（systemic inflamma-tion response syndrome，SIRS)的发生。当机体受到创伤等严重打击后，体内相续启动一系列复杂的细胞生物学效应，包括应激信号的激活和传递、炎症反应失衡、各种有害因素的释放等。现代研究发现，创伤后患者体内p38MAPK（丝裂原激活的蛋白酶）的激活以及TNFα和IL￣6等的表达水平都迅速上调，且都与创伤程度呈正相关。炎症反应在创伤的病理过程中发挥了重要的作用，也可能是部分创伤并发症（脓毒症、多器官衰竭、高代谢、深静脉血栓形成等）的诱因。 TNFα、IL￣1、IL￣6、C￣反应蛋白等均是创伤后炎症反应的敏感指标，能反应创伤患者的病情，评价炎症反应的严重程度。通过早期监测这些重要指标，采取适当的措施阻止炎症反应的进一步发展，以有效降低MODS发生率，减少创伤患者死亡率。本文就创伤后早期炎症因子TNF￣a、IL￣1、IL￣6变化情况的研究进展做一综述。
創傷是各種緻傷因素造成的人體組織損傷和功能障礙，嚴重創傷導緻全身炎癥反應綜閤徵（systemic inflamma-tion response syndrome，SIRS)的髮生。噹機體受到創傷等嚴重打擊後，體內相續啟動一繫列複雜的細胞生物學效應，包括應激信號的激活和傳遞、炎癥反應失衡、各種有害因素的釋放等。現代研究髮現，創傷後患者體內p38MAPK（絲裂原激活的蛋白酶）的激活以及TNFα和IL￣6等的錶達水平都迅速上調，且都與創傷程度呈正相關。炎癥反應在創傷的病理過程中髮揮瞭重要的作用，也可能是部分創傷併髮癥（膿毒癥、多器官衰竭、高代謝、深靜脈血栓形成等）的誘因。 TNFα、IL￣1、IL￣6、C￣反應蛋白等均是創傷後炎癥反應的敏感指標，能反應創傷患者的病情，評價炎癥反應的嚴重程度。通過早期鑑測這些重要指標，採取適噹的措施阻止炎癥反應的進一步髮展，以有效降低MODS髮生率，減少創傷患者死亡率。本文就創傷後早期炎癥因子TNF￣a、IL￣1、IL￣6變化情況的研究進展做一綜述。
창상시각충치상인소조성적인체조직손상화공능장애，엄중창상도치전신염증반응종합정（systemic inflamma-tion response syndrome，SIRS)적발생。당궤체수도창상등엄중타격후，체내상속계동일계렬복잡적세포생물학효응，포괄응격신호적격활화전체、염증반응실형、각충유해인소적석방등。현대연구발현，창상후환자체내p38MAPK（사렬원격활적단백매）적격활이급TNFα화IL￣6등적표체수평도신속상조，차도여창상정도정정상관。염증반응재창상적병리과정중발휘료중요적작용，야가능시부분창상병발증（농독증、다기관쇠갈、고대사、심정맥혈전형성등）적유인。 TNFα、IL￣1、IL￣6、C￣반응단백등균시창상후염증반응적민감지표，능반응창상환자적병정，평개염증반응적엄중정도。통과조기감측저사중요지표，채취괄당적조시조지염증반응적진일보발전，이유효강저MODS발생솔，감소창상환자사망솔。본문취창상후조기염증인자TNF￣a、IL￣1、IL￣6변화정황적연구진전주일종술。
Trauma is the body tissue damage and dysfunction caused by various injury factors. Se-vere trauma leads to the occurrence of systemic inflammation response syndrome, SIRS. When the body is hit severely, for example trauma and etc., a series of complex effects of cell biology have been started in one’s body, including activation and transfer of stress signals, imbalance of in-flammations, release of various harmful factors and etc. Modern research has found that the acti-vation of p38MAPK and the expression levels of TNFα, IL￣6 and etc. are increasing rapidly in patients'body after trauma, and they are positively correlated with the degree of trauma. Inflamma-tion plays an important role in the pathological process of trauma. It may also be the incentive of some trauma complications (sepsis, multiple organ failure, high metabolism, deep vein thrombosis, etc.). TNFα, IL￣1, IL￣6, C￣reactive protein and etc. are sensitive indicators of post￣traumatic in-flammation. It is able to respond to the condition of trauma patient, and evaluate the severity of the inflammation. By early monitoring of these important indicators, taking appropriate measures to prevent the further development of inflammation, can effectively reduce the incidence of MODS and mortality of trauma patients. This article makes a summary on the research progress of changes of early post￣traumatic inflammation cytokines TNF￣a, IL￣1, IL￣6.
