烧伤后血清炎症因子TNF―α值的变化与临床意义.docVIP

烧伤后血清炎症因子TNF―α值的变化与临床意义[摘要] 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（P0.01）。（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（P0.01），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（P0.05）。（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。[关键词] 烧伤；血清炎症因子；肿瘤坏死因子-α；病情评估[中图分类号] R644 [文献标识码] B [文章编号] 2095-0616（2015）01-210-04[Abstract] Objective To detect and study the change and the change law of serumal inflammatory factor TNF-α after 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（P0.01）. （2）There were significant differences of TNF-α between Ⅲ burn group and Ⅰburn group in the same period（P0.01）， while there were significant differences of TNF-α between Ⅲ burn group and Ⅱ burn group at the 7th days（P0.05）. （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 in Ⅰburn 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 bur