创伤后多器官功能不全综合征抗炎症反应和免疫抑制

摘要

目的　研究创伤后多器官功能不全综合征的 抗炎症反应和免疫功能状况。方法　用ELISA法测定了33例创伤患者血浆 IL-4、10、12、13水平。结果　(1)所有患者不论是否出现SIRS、器官衰 竭，血浆中均未测出IL-4。(2)血浆IL-10水平随器官衰竭数目的增加而升高（P ＜0.05）；SIRS组、死亡组IL-10水平较非SIRS组、存活组明显升高（P ＜0.01）。(3)SIRS组血浆IL-12水平较正常组和无SIRS组高（P＜0.05）。存活组血浆IL-12水平较死亡组高，提示血浆IL-12水平升高的创伤患者预后较 好。(4)SIRS组、死亡组血浆IL-13水平与非SIRS组、存活组比较无明显差异，但较正常 组升高(P＜0.05)。结论　创伤后多器官功能 不全综合征抗炎症反应占主导，免疫抑制的患者预后多不良。%Objective　Thirty-three traumatic patients［m ean injury severity score （ISS）21.8±5.8, 18 cases ISS 18-25,15 cases ISS≥25 ］with MODS were involved in this research to testify their parameters of CARS a nd immunity.Methods　ELISA was utilized to detect plasma inter leukin(IL)-4，10，12，13.Results　(1)IL-4 was negatively measu red in all patients whether SIRS, organ failure existed or not.(2) With the in crease of number of organ failure, level of IL-10 was elevated (P <0.05). IL-10 of SIRS and dead groups was very significantly increase d than that of non-SIRS group and the survival group.(3)High IL-12 concentrat ion was found in the survival group than that in the dead group (P＜0.05).(4)No significant difference of IL-13 was discovered bet ween SIRS and non-SIRS groups,but higher than the control group(P ＜0.05). Conclusion　Posttraumatic patients with elev ated plasma IL-10 and low plasma IL-12 may be suscep tible to MODS with high mortality.