重庆医学2012，Vol.41Issue(8)：738-740,743,4.DOI:10.3969/j.issn.1671-8348.2012.08.004
系统性炎症反应综合征患者血浆D-二聚体与细胞因子动态变化的研究
A study of dynamic changes of plasma D-dimer and cytokine of patients with systemic inflammatory response syndrome
摘要
Abstract
Objective To explore the dynamic changes of plasma D-dimer, interleukin-6(IL-6) and tumor necrosis factor alpha (TNF-α) of patients with systemic inflammatory(SIRS) and their influences on prognosis. Methods 50 patients with SIRS hospitalized from January 2008 to January 2010 in our hospital served as SIRS group which was subdivided into simple SIRS group (n = 26)and MODS group(n = 24) according to whether MODS occurred,and subdivided into survival group(n = 35) and death group (n=15) ,according to their prognosis. Their plasma D-dimer, IL-6 and TNF-α were detected on the 1st, 3rd, 5th and 7th day after SIRS occurred,and their APACHE Ⅱ scores were recorded. Another 35 patients hospitalized in general medicine department served as non-SIRS group and 30 healthy people served as control group. The relations between plasma contents of D-dimer and APACHEⅡ score,IL-6 ,TNF-α of patients with SIRS, respectively, were subjected to Pearson correlation analysis. Results The contents of plasma D-dimer,IL-6 and TNF-α of patients in simple SIRS group and MODS group were significantly increased when compared with non-SIRS group and control group(P<0. 01). Compared with the 3rd day and the 1st day after SIRS occurred,plasma D-dimer content of patients in both survival group and death group showed no significant difference(P>0. 05). Plasma D-dimer content of patients in death group was markedly higher than that in survival group(P<0. 05). Compared the plasma contents of IL-6 and TNF-a of patients between survival group and death group on the 1st,3rd,5th and 7 th day after SIRS occurred, differences were found to be statistically significant (P<0.01). D-dimer content of patients with SIRS showed positive correlation with A-PACHEⅡ score,IL-6 and TNF-α contents(r= 0. 453,0. 342,0. 340 ,respectively, P<0. 01). Conclusion IL-6 and TNF-α participate in coagulation disorder of patients with SIRS,D-dimer has positive correlation with disease severity,and sustaining high levels of plasma D-dimer, IL-6 ,TNF-α indicate a poor prognosis.关键词
系统性炎症反应综合征/多器官功能衰竭/白细胞介素类/肿瘤坏死因子α/D-二聚体Key words
systemic inflammatory response syndrome/ multiple organ failure/ interleukins/ tumor necrosis factor-alpha/ D-dimer引用本文复制引用
龙鼎,喻莉,武晓灵..系统性炎症反应综合征患者血浆D-二聚体与细胞因子动态变化的研究[J].重庆医学,2012,41(8):738-740,743,4.基金项目
武汉市卫生局临床医学科研资助项目(WX08D10). （WX08D10）
