目的探讨急性一氧化碳中毒患者早期血清中肿瘤坏死因子（T N F-α）和白细胞介素（IL-10）的表达及意义。方法收集荆门市第一人民医院急诊科既往健康的急性一氧化碳中毒患者128例，按照急性一氧化碳中毒诊断及病情分级标准分为轻度中毒组、中度中毒组和重度中毒组。收集30例健康体检者作对照组。分别于入院时对患者进行APACHEⅡ评分，并抽取静脉血，用ELISA方法测定血清中TNF-α和IL-10的浓度。结果 APACHEⅡ评分随患者病情加重而升高，差异具有统计学意义（P＜0.05）。对照组、轻度中毒组、中度中毒组、重度中毒组患者血清中 TNF-α依次升高，组间比较差异具有统计学意义（P＜0.05）。TNF-α水平与APACHEⅡ评分呈正相关性。各组中毒患者血清中IL-10浓度略高于对照组，差异无统计学意义（P＞0.05）。IL-10与APACHEⅡ评分无相关性。TNF-α/IL-10比值与APACHEⅡ评分呈正相关性（P＜0.01）。结论n 急性一氧化碳中毒患者TNF-α水平升高，且水平随病情加重而升高；促炎因子与抗炎因子平衡失调与急性一氧化碳中毒病情程度相关，可作为病情评估的指标。%Objective To investigate the expression and significance of early-stage serum tumor necrosis factor-α(TNF-α) and interieukin-10 (IL-10) in patients with acute carbon monoxide poisoning (ACOP) .Methods One hundred and Twenty-eight cases of ACOP were divided into mild group ,moderate group and severe group according to the diagnosis standard .Thirty healthy volunteers were served as control group .APACHE Ⅱ scores were evaluated for these patients and their serum concen-trations of TNF-αand IL-10 were detected by enzyme-linked immunosorbent assay (ELISA) .Results APACHE Ⅱ scores in-creased significantly with the exacerbations of ACOP (P<0.05).The expression of TNF-αincreased with the exacerbations of ACOP (P<0.05).The serum TNF-αconcentrations positively correlated with APACHE Ⅱ scores.The serum IL-10 concen-trations of ACOP was slightly higher than the control group. There was no significant difference compared with the control group (P>0.05). However ,the ratio of TNF-α/IL-10 positively correlated with APACHE Ⅱ scores ( P<0.01).Conclusion There are inflammatory responses in the process of ACOP. Imbalance between inflammation promoting factor and inhibiting factors is correlated with the severity of ACOP ,which may be an important mechanism of ACOP.
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