摘要
目的:研究 MODS 患者 sTNFR I 的变化,及其与预后的关系。方法:应用 ELISA 方法,对2002年11月至2003年3月长海医院中心 ICU 符合 MODS 条件的24例病人进行不同时段血 sTNFR I、TNF-α的检测,并设立正常对照组。结果:各实验组患者(MODS 存活组、MODS 死亡组)在入 ICU 当时至第3天 sTNFR I 及TNF-α与正常对照组比较均有明显差异(P<0.01),MODS 存活组和 MODS 死亡组血 sTNFR I 差异均明显(P<0.01)。第1天血 sTNFR I 与模拟 APACHEII 评分在 MODS 存活组呈正相关(r=0.62,P<0.01),MODS 死亡组呈负相关(r=-0.65,P<0.01)。患者伤后第1天血 sTNFR I>450pg/ml 提示 MODS 发生,但预后尚好,灵敏度、特异度均高。结论:监测重症患者血液内 sTNFR I 的动态变化对患者伤情判断、预后具有重要临床意义。
To investigate the changes in soluble tumor necrosis factor receptor I(sTNFR I)in patients with MODS.Methods:The plasma levels of sTNFR I and TNF-a in 24 patients with MODS were determined at different time points with ELISA.Results:In patients,plasma sTNFR I levels were elevated remarkably compared with the nomal controls(P<0.01)on day 3 after injury.There was significant difference between survivors and non-survivors(P<0.05),sTNFR I had a negative correlation with APACHE Ⅱ in non-survivors,but had a posi- tive correlation in the other groups.When sTNFR I level excceded 450pg/ml,it predicted the development of MODS and there would be a fine prognosis.The sensitivity and specificity of this criterion was 80% and 96% re- spectively.Conclusion:The monitoring of the changes in plasma levels of sTNFR I might be helpful in the pregno- sis of the forecast of the development of MODS.
出处
《感染．炎症．修复》
2004年第3期89-91,共3页
Infection Inflammation Repair
基金
国家自然科学基金(39970720)
