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目的探讨肿瘤坏死因子-α(TNF-α)、内毒素(LPS)、白细胞介素-6(IL-6)、磷脂酶A_2(PLA_2)与重症胸腹损伤后心肌细胞损伤发生的关系。方法收集2009年1月—2013年6月在我院急诊科就诊,创伤指数(TI)≥17分,除外合并颅脑损伤及在急诊死亡的胸腹损伤患者112例,在救治的同时检查肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、TNF-α、LPS、IL-6、PLA_2,对检验结果进行相关性分析。结果心肌损伤:CK-MB:(218.79±21.59)U/L,cTnT:(546.25±29.34)ng/L;损伤因子:TNF-α:(39.61±13.09)μg/L,LPS:(453.68±96.37)IU/L,IL-6:(436.83±1 13.86)μgg/L,PLA_2:(48.35±1 2.26)μg/L。CK-MB与TNF-α、LPS、IL-6、PLA_2比较相关系数(r)均>0.883 2,cTnT与TNF-α、LPS、IL-6、PLA_2比较r均>0.889 1,均呈显著正相关。结论 TNF-α、LPS、IL-6、PLA_2参与了重症胸腹损伤后心肌细胞损伤的发生,对TNF-α、LPS、IL-6、PLA_2的针对性干预,或有可能减轻重症胸腹损伤后心肌细胞损伤的程度,提高重症胸腹损伤者的生存率。
Objective To investigate the relationship between tumor necrosis factor-α (TNF-α), endotoxin (LPS), interleukin-6 (IL-6) and phospholipase A2 (PLA2) Methods A total of 112 patients with chest and abdomen injury who had craniocerebral injury and emergency death were enrolled in the emergency department of our hospital from January 2009 to June 2013. The patients were examined for muscle CK-MB, cTnT, TNF-α, LPS, IL-6 and PLA_2. Results Myocardial injury: CK-MB: (218.79 ± 21.59) U / L, cTnT: (546.25 ± 29.34) ng / L; ) IU / L, IL-6: (436.83 ± 1 13.86) μgg / L, PLA_2: (48.35 ± 1.26) μg / L. The correlation coefficient (r) between CK-MB and TNF-α, LPS, IL-6 and PLA_2 were all> 0.883 2, r = 0.889 1 between cTnT and TNF-α, LPS, IL-6 and PLA_2 Related. Conclusions TNF-α, LPS, IL-6 and PLA_2 are involved in the cardiomyocyte injury following severe thoracoabdominal injuries. Targeted intervention of TNF-α, LPS, IL-6 and PLA_2 may reduce the risk of severe thoraco- After myocardial cell injury, improve the survival rate of patients with severe chest and abdomen injury.