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目的:本研究观察胸部外伤所致肺水肿病人血中E-选择素、TNF、白细胞介素-8和内皮素的变化。方法:用固相双夹心酶联免疫吸附法和放免技术共测定了24例胸部外伤病人在治疗前后血中E-选择素、肿瘤坏死因子、白细胞介素-8和内皮素浓度。结果:临床肺水肿病人血中E-选择素、肿瘤坏死因子、白细胞介素-8和内皮素的浓度在发病时明显升高,与正常对照组比较,差异有显著性(P<0.001)。治愈后恢复正常,治疗后各项指标与正常对照组比较差异元显著性(P>0.05),但治疗前后差异有显著性(P<0.001)。结论:E-选择素、肿瘤坏死因子、白细胞介素-8和内皮素在肺水肿发病机制中起着重要,随着这些因子的升高出现肺水肿并逐渐加重,这些因子降低后肺水肿逐步消失。因此对这些因子的检测有助于估计病情和评价疗效。
Objective: This study was to observe the changes of blood E-selectin, TNF, interleukin-8 and endothelin in patients with pulmonary edema caused by thoracic trauma. Methods: The serum concentrations of E-selectin, tumor necrosis factor, interleukin-8 and endothelin in 24 patients with chest trauma were measured before and after treatment with solid-phase double-sandwich enzyme-linked immunosorbent assay and radioimmunoassay. Results: The concentrations of E-selectin, tumor necrosis factor, interleukin-8 and endothelin in patients with clinical pulmonary edema were significantly increased at the onset of disease. The difference was significant (P <0.001) compared with the normal control group. After treatment, all the indexes returned to normal after treatment. There was a significant difference (P> 0.05) between the index and the normal control group after treatment, but there was significant difference between before and after treatment (P <0.001). CONCLUSIONS: E-selectin, tumor necrosis factor, interleukin-8 and endothelin play important roles in the pathogenesis of pulmonary edema. Pulmonary edema develops as these factors increase and progressively worsens. Pulmonary edema following these decreases disappear. Therefore, the detection of these factors help to estimate the disease and evaluate the efficacy.