急性创伤出血病人IL6、IL8和TNFα的检测_医学论文.docVIP

急性创伤出血病人IL6、IL8和TNFα的检测_医学论文 急性创伤出血病人IL6、IL8和TNFα的检测_医学论文 【摘要】 目的 探讨急性创伤出血病人白细胞介素6(IL6)、白细胞介素8(IL8)和肿瘤坏死因子α(TNFα)变化及其意义。方法 将外伤30 min内急诊病人分为软组织挫伤伴出血组(A组)25例、锐器刺割伤致出血组(B组)25例，以健康体检者25例作为对照组(C组)。取外周血浆标本，采用酶联免疫分析(ELISA)法检测IL6、IL8和TNFα水平。结果 A组和B组IL6水平均升高，且A组升高明显，3组间相比较差异均有统计学意义(F=21.750,q=3.559～6.994，0.01)。A组IL8水平明显升高，且与B、C组相比较差异均有统计学意义(F=55.314，q=7.382、7.843，0.01)。A组TNFα水平明显升高，且与B、C组相比较差异均有统计学意义(F=3.504，q=2.024、2.393，0.05)。结论 急性挫伤伴出血比锐器刺割伤致出血更易引起IL6、IL8、TNFα水平升高，提示创伤后急性失血时免疫细胞分泌大量炎性因子，加重组织损伤。 【关键词】 创伤和损伤出血白细胞介素6白细胞介素8肿瘤坏死因子α [ABSTRACT] Objective To investigate the changes and their significance of IL6, IL8, and TNFα in patients with acute traumatic bleeding. Methods Patients injured within 30 minutes were enrolled in this study, 25 in each group: patients with bleeding due to softtissue contusion served as group A and those suffered from stab or slash by sharp instrument injury as group B. Group C, consisted of 25 healthy subjects who came for body check, as controls. Peripheral plasma IL6, IL8 and TNFα were detected by ELISA method. Results The levels of IL6 in groups A and B increased, more obviously in group A, with statistical differences among the three groups (F=21.750q=3.559-6.9940.01). In group A, IL8 rose dramatically, compared with groups B and C (F=55.314q=7.382,7.8430.01), and TNFα elevated markedly compared with that of groups B and C(F=3.504q=2.024,2.3930.05). Conclusion Bleeding caused by acute contusion is easier than stab wound to produce the changes of IL6, IL8 and TNFα levels, which indicates that acute blood loss leads to a great quantity of inflammatory factors secreted by immunocytes, aggravating tissue injuries. 　　[KEY WORDS] wounds and injuries hemorrhage interleukin6 interleukin8 tumor necrosis factoralpha 　　白细胞介素6(IL6)、白细胞介素8(IL8)和肿瘤坏死因子α(TNFα)为促炎细胞因子，具有局部和全身作用，能限制损伤和炎症的扩大，并为组织愈合和修复提供适宜的环境，而组织损伤程度与细胞因子有一定的相关性。有关急性失血和休克不同时期 IL6、IL8和TNFα的变化国内外尚少见报道。本实验通过测定急性创伤出血时上述细胞因子含量变化，旨在为创伤失血性休克与细胞因子相关性提供理论依据。现报告如下。