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目的:探讨TNF-α和TGF-β1在急性有机磷农药中毒(AOPP)中的临床意义。方法:选取既往健康的急性中毒患者42例,分别于来院即刻抽静脉血,保存至采用放免分析法同批测定血清中TNF-α、TGF-β1含量,与20例健康献血者对照,比较不同病情患者血清中TNF-α、TGF-β1含量,不同预后患者血清中TNF-α、TGF-β1含量及TGF-β1/TNF-α比值。结果:急性药物中毒患者血清TNF-α、TGF-β1明显升高,随病情加重增加更明显,死亡组患者TGF-β1/TNF-α失衡患者比例高于存活组。结论:在AOPP时,机体同时存在促炎反应和抗炎反应,炎症介质和抗炎介质的过度释放及二者平衡失调是AOPP引发多器官功能障碍综合征(MODS)的重要发病机制之一。
Objective: To investigate the clinical significance of TNF-α and TGF-β1 in acute organophosphorus pesticide poisoning (AOPP). Methods: Forty-two acutely poisoned patients were recruited to receive venous blood immediately before admission to hospital. The serum levels of TNF-α and TGF-β1 were determined by radioimmunoassay in the same batch, compared with 20 healthy blood donors Serum levels of TNF-α and TGF-β1 in patients with disease and the serum levels of TNF-α and TGF-β1 and TGF-β1 / TNF-α in patients with different prognosis. Results: Serum levels of TNF-α and TGF-β1 in patients with acute drug-induced poisoning were significantly higher than those in survivors. The proportion of patients with TGF-β1 / TNF-α imbalance in death group was significantly higher than that in survivors. Conclusions: At the same time of AOPP, there are both proinflammatory and antiinflammatory reactions in the body. The excessive release of inflammatory mediators and antiinflammatory mediators and the imbalance between them are one of the important pathogenesis of AOPP in multiple organ dysfunction syndrome (MODS).