儿童全身炎症反应综合征内毒素水平及IL6、IL10、TNFα及PC.docVIP

儿童全身炎症反应综合征内毒素水平及IL6、IL10、TNFα及PC 　 【摘要】 目的 探讨儿童全身炎症反应综合征(SIRS)时内毒素、IL6、IL10、肿瘤坏死因子α(TNFα)及降钙素原(PCT)的浓度变化，并对内毒素与IL6、IL10、TNFα、PCT进行相关性分析。方法 酶联免疫吸附法测定IL6、IL10、TNFα、PCT；鲎试剂显色基质试管法测定内毒素。结果 IL6、IL10、TNFα、PCT及内毒素水平在SIRS时均明显高于对照组；内毒素水平在单器官损害/重度感染组入院d1出现波峰；多器官损害组未见波峰出现，峰值呈上升趋势。PCT于入院d1达峰值，以后逐渐下降；TNFα、IL6及IL10一直处于较高水平，并与病情呈正相关。结论 内毒素水平与IL6、IL10、TNFα变化存在一定程度正相关，并随时间推移和病情加重逐渐增高。内毒素、PCT与SIRS病情严重程度相关，可以作为SIRS病情变化的早期、特异的监测指标。 【关键词】 儿童全身炎症反应综合症； 内毒素； IL6； IL10； 肿瘤坏死因子α； 降钙素原 ABSTRACT ObjectiveTo detect the changes of endotoxin, interleukin6 (IL6), interleukin10 (IL10), tumor necrosis factorα (TNFα) and procalcitonin (PCT) in pediatric patients with systemic inflammatory response syndrome (SIRS) and analyze the correlation of endotoxin to IL6, IL10, TNFα and PCT. Methods The 1evels of endotoxin, IL6, IL10, TNFα and PCT were detected by enzyme linked immunosorbent assay. The level of endotoxin in plasma was detected by Chromogenic EndPoint TAL. Results The levels of endotoxin, IL6, IL10, TNFα and PCT in patients were obviously higher than those in control group (Plt;0.01). Endotoxin levels peaked on the first day in the group of nonorgan injured/infected seriously, but in the group of injured polyorgan there was no peak levels and increased constantly. PCT levels peaked on day one of admission, then decreased gradually. PCT decreased obviously on the third days and on the fifth days. TNFα, IL6 and IL10 were also maintained higher levels all the time. Conclusion Endotoxin levels were correlated with the level of IL6, IL10, TNFα, and increased in the progress and with the existing diseases. The levels of endotoxin and PCT had some relationship with the existing diseases in patients during SIRS, and they could be used to monitor the SIRS patients′ clinical condition and the disposition therapy. KEY WORDS Systemic inflammatory response syndrome endotoxin interleukin6 interleukin10 tumor necrosis factora procalcitonin 论文