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目的 探讨血浆肿瘤坏死因子α(TNF α)在重度急性有机磷农药中毒(AOPP)并发呼吸衰竭发生发展中的作用及临床意义。方法 采用酶联免疫吸附法(ELISA)动态监测56 例重度AOPP患者血浆TNF α水平。结果 正常对照组20例血浆TNF α水平为(11.41±3.78)pg/ml。在入院后即刻、中毒后12 h和第1、2、3、4、5、7天,56例重度AOPP患者血浆TNF α水平均高于对照组,呼吸衰竭(呼衰)组患者血浆TNF α水平高于非呼吸衰竭(非呼衰)组患者,差异均有统计学意义(P<0.01);呼衰组患者血浆TNF α水平峰值的出现时间与呼吸衰竭发生的时间相符合。结论 重度AOPP早期就出现了炎性细胞因子的产生和释放;TNF α可能参与了重度AOPP后呼吸衰竭的发病过程。
Objective To investigate the role and clinical significance of plasma tumor necrosis factor α (TNF α) in the development of severe acute organophosphorus pesticide poisoning (AOPP) associated with respiratory failure. Methods The levels of plasma TNFα in 56 patients with severe AOPP were detected by enzyme-linked immunosorbent assay (ELISA). Results The plasma levels of TNFα in the control group were (11.41 ± 3.78) pg / ml. Immediately after admission, 12 h and 1, 2, 3, 4, 5 and 7 days after poisoning, the plasma levels of TNFα in 56 patients with severe AOPP were significantly higher than those in the control group. The levels of plasma TNFα (P <0.01). The peak time of plasma TNFα in patients with respiratory failure was coincident with the time of respiratory failure. Conclusions The production and release of inflammatory cytokines appeared early in severe AOPP. TNFα may be involved in the pathogenesis of respiratory failure after severe AOPP.