CAJ | 학술논문

目的：检测烧伤后患者体内炎症因子TNF-α值在不同时间点的变化，研究其在烧伤后的变化规律，探讨检测烧伤后TNF-α值的临床意义。方法选择烧伤患者79例，按照烧伤总体表面积不同分为三组，分别收集烧伤后1、3、7、14、21d患者的血清，利用酶联免疫吸附试验法（ELISA）检测血清中TNF-α值，与30例健康献血人员血清TNF-α值进行比较。结果（1）与对照组相比，三组烧伤患者血清中TNF-α值在烧伤后1、3、7d时均显著增高（P＜0.01）。（2）烧伤Ⅲ组TNF-α水平与同时期烧伤Ⅰ组TNF-α水平具有统计学差异（P＜0.01），烧伤Ⅲ组TNF-α水平与烧伤7d后Ⅱ组TNF-α水平具有统计学差异（P＜0.05）。（3）烧伤Ⅰ组、Ⅱ组TNF-α值在烧伤后3d达高峰，后出现不同程度的降低，烧伤Ⅰ组21d接近正常，烧伤Ⅱ组TNF-α值在伤后21d仍处于较高水平。烧伤Ⅲ组TNF-α值一直缓慢升高，并持续较长时间。结论炎症因子TNF-α值在烧伤后不同时间点的变化，同体表烧伤面积、病情变化及烧伤愈合程度等多种因素有关，在病情分级的基础上早期联合监测烧伤患者血清NF-α值的变化，对判断烧伤病情的严重程度、协助指导治疗、评估预后具有一定的帮助。
목적：검측소상후환자체내염증인자TNF-α치재불동시간점적변화，연구기재소상후적변화규률，탐토검측소상후TNF-α치적림상의의。방법선택소상환자79례，안조소상총체표면적불동분위삼조，분별수집소상후1、3、7、14、21d환자적혈청，이용매련면역흡부시험법（ELISA）검측혈청중TNF-α치，여30례건강헌혈인원혈청TNF-α치진행비교。결과（1）여대조조상비，삼조소상환자혈청중TNF-α치재소상후1、3、7d시균현저증고（P＜0.01）。（2）소상Ⅲ조TNF-α수평여동시기소상Ⅰ조TNF-α수평구유통계학차이（P＜0.01），소상Ⅲ조TNF-α수평여소상7d후Ⅱ조TNF-α수평구유통계학차이（P＜0.05）。（3）소상Ⅰ조、Ⅱ조TNF-α치재소상후3d체고봉，후출현불동정도적강저，소상Ⅰ조21d접근정상，소상Ⅱ조TNF-α치재상후21d잉처우교고수평。소상Ⅲ조TNF-α치일직완만승고，병지속교장시간。결론염증인자TNF-α치재소상후불동시간점적변화，동체표소상면적、병정변화급소상유합정도등다충인소유관，재병정분급적기출상조기연합감측소상환자혈청NF-α치적변화，대판단소상병정적엄중정도、협조지도치료、평고예후구유일정적방조。
Objective To detect and study the change and the change law of serumal inflammatory factor TNF-αafter burn at different time points, to discuss and study the clinical significance of TNF-α after burn. Methods 79 burn patients were selected to divided into three groups according to the difference of burn area. To compared the serumal inflammatory factor TNF-α which was detected by immunosorbent assays (ELISA) of burn patients with 30 healthy blood donators, through the serumal selection of patients after burn, at the 1st, 3rd, 7th, 14th, 21st days. Results(1)The serumal TNF-α of burn patients of the three groups were significantly increased after burn compared with control group at the 1st, 3rd, 7th days(P < 0.01).(2)There were significant differences of TNF-αbetween Ⅲ burn group and Ⅰ burn group in the same period(P < 0.01), while there were significant differences of TNF-α between Ⅲ burn group and Ⅱ burn group at the 7th days(P<0.05).(3)TNF-α of Ⅰ、Ⅱ burn group had reached the peak at the 3rd days, and then had reduced in different degree. TNF-α of had close to normal inⅠburn group and which also had a high level in Ⅱ burn group at the 21st days. TNF-α had increased slowly over a long period of time in Ⅲ burn group. Conclusion The change of serumal inflammatory factor TNF-α after burn at different time points is correlated with the burn area of body surface, the change of illness, and the degree of burn wound healing. Based on the disease grades and early combinative monitoring of the change of serumal TNF-, to judge the burn severity, to help and to guide the treatment and prognostic evaluation.