中重度烧伤合并脓毒血症患者TFPI_TF_TNF_的变化

中重度烧伤合并脓毒血症患者

TFPI、TF、TNF-α的变化

闵定宏a，余绍青b，陈国安c，郭菲a，李国辉a

（南昌大学第一附属医院a.烧伤中心;b.干部病房;c.血液科，南昌330006）

摘要：目的通过测定中重烧伤合并脓毒血症患者组织因子途径抑制物（TFPI）、组织因子（TF）和肿瘤坏死因子-α（TNF-α）的水平，了解TFPI、TF、TNF-α与感染及其严重程度的关系。方法选取中重度烧伤合并脓毒血症患者30例（烧伤组），按病程的前后分为：感染前期组（烧伤后72h～7d内）；感染后期组（感染后期组，烧伤后10～14d）。选取同期健康献血员20例（对照组）。用酶联免疫吸附法测定各组TFPI、TF、TNF-α水平。结果与对照组比较，感染前期组TFPI、TF及TNF-α抗原含量明显升高（P＜0.01）；感染后期组TF、TNF-α明显升高（P＜0.01），但TFPI抗原含量无统计学意义（P＞0.05）。与感染前期组比较，感染后期组TFPI抗原含量明显减低（P＜0.05）。感染前期组TFPI与TF、TNF-α呈正相关（r=0.763、r=0.835，P＜0.05）；感染后期组TFPI与TF、TNF-α呈负相关（r=-0.873、r=-0.363，P＜0.05）。

结论中重度烧伤合并脓毒血症患者血浆中TF/TFPI的不断升高及TFPI/TNF-α的持续下降可以作为脓毒血症病情变化的监测指标。

关键词：组织因子途径抑制物；组织因子；肿瘤坏死因子-α；脓毒血症；烧伤，中重度

中图分类号：R644文献标志码：A文章编号：1009-8194（2012）12-0012-03

Changes in Tissue Factor Pathway Inhibitor,Tissue Factor and Tumor Necrosis Factor-αin Moderate and Severe Burn

Injuries Complicated by Intercurrent Sepsis

MIN Ding-hong a,YU Shao-qing b,CHEN Guo-an c,GUO Fei a,LI Guo-hui a （a.Burn Center;b.Cadre Ward；c.Department of Hematology,the First Affiliated Hospital of Nanchang

University,Nanchang330006,China）

A BSTRACT：Objective To inve stigate the relationships of tissue factor pathway inhibitor（TFPI）,

tissue factor（TF）and tumor necrosis factor-α（TNF-α）to the infection and its degree.Methods Thi-rty patients with moderate and severe burn injuries and intercurrent sepsis were divided into early stages of infection group（3-7days after burn）and late stages of infection group（10-14days after burn）.

In addition,20healthy blood donors were selected as control group.The levels of TFPI,TF and TNF-αwere detected by using ELISA assay.Results Compared with control group,antigenic content of TFPI,TF and TNF-αsignificantly increased in early stages of infection group（P＜0.01）.TF and TNF-αsignificantly increased（P＜0.01），no signifi-cant differences in antigenic content of TFPI were found between control group and late stages of infec-tion group（P＞0.05）.Compared with early stages of infection group,antigenic content of TFPI obviously decreased in late stages of infection group（P＜

0.05）.The TFPI was positively correlated with TF and TNF-αin early stages of infection group（r=

0.763、r=0.835，P＜0.05）,but negatively correlated with TF and TNF-αin late stages of infection group

（r=-0.873、r=-0.363，P＜0.05）.Conclusion The increase in plasma TF/TFPI levels and the decrease in plasma TFPI/TNF-αlevels can be used as the monitoring indicators for judging the changes in condition in patients with moderate and severe burn injuries and intercurrent sepsis.

KEY WORDS：tissue factor pathway inhibitor;tissue factor;tumor necrosis factor-α;sepsis;

burn,moderate and severe

收稿日期：2012-10-12

基金项目：江西省教育厅科技计划（2007-72）

作者简介：闵定宏（1964—），男，学士，主任医师，副教授，主要从事创面处理、烧伤脓毒血症的研究。