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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2008, Vol. 02 ›› Issue (01) : 32 -34. doi: 10.3877/cma.j.issn.1674-0793.2008.01.011

论著

失血性低血容量休克多器官功能障碍综合征的机制探讨
吴泽宇1, 万进1,†(), 管向东2, 杜嘉林1   
  1. 1.510080 广州，广东省人民医院普外三科
    2.510080 广州，中山大学附属第一医院SICU
  • 收稿日期:2007-03-14 出版日期:2008-02-01
  • 通信作者: 万进

Mechanism of multiple organ dysfunction syndrome results from hemorrhagic hypovolemic shock

Ze-yu WU1, Jin WAN1,†(), Xiang-dong GUAN1, Jia-lin DU1   

  1. 1.Department of General Surgery,Guangdong Provincial People’s Hospital,Guangzhou 510080,China.
  • Received:2007-03-14 Published:2008-02-01
  • Corresponding author: Jin WAN
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吴泽宇, 万进, 管向东, 杜嘉林. 失血性低血容量休克多器官功能障碍综合征的机制探讨[J/OL]. 中华普通外科学文献(电子版), 2008, 02(01): 32-34.

Ze-yu WU, Jin WAN, Xiang-dong GUAN, Jia-lin DU. Mechanism of multiple organ dysfunction syndrome results from hemorrhagic hypovolemic shock[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2008, 02(01): 32-34.

目的

探讨失血性低血容量休克病人血清肿瘤坏死因子-α（TNF-α）和白细胞介素-1（IL-1）水平与预后的关系。

方法

应用ELISA法检测29例失血性低血容量休克病人（休克组）血清TNF-α和IL-1浓度，与20例择期手术病人（对照组）进行比较，观察TNF-α和IL-1水平与多器官功能障碍综合征(MODS)的关系。

结果

休克组全身炎症反应综合征(SIRS)、MODS和感染的发病率明显高于对照组(P＜0.05)；休克组血清TNF-α和IL-1浓度明显高于对照组(P＜0.05)； MODS组血清TNF-α浓度较非MODS组明显升高(P＜0.05)，血清IL-1浓度差异无显著性(P ＞0.05)；休克组中死亡病人血清TNF-α浓度较存活病人明显增高(P＜0.05)，血清IL-1浓度差异无显著性(P ＞0.05)。

结论

失血性低血容量性休克发生SIRS是较为常见的，并且是导致MODS的重要原因之一；血清TNF-α浓度的高低与预后密切相关。

关键词: 休克, 出血性, 多器官功能障碍综合征, 全身炎症反应综合征, 肿瘤坏死因子-α, 白细胞介素-1

Objective

To investigate the relationship between serum levels of TNF-α and IL-1 and prognosis of hemorrhagic hypovolemic shock.

Methods

The serum levels of TNF-α and IL-1 were measured by ELISA in 29 hemorrhagic hypovolemic shock patients,20 patients for selective surgery served as a control group.The relationship between serum levels of TNF-α, IL-1 and MODS were analyzed.

Results

The morbidity rates of SIRS, MODS and infection in hemorrhagic hypovolemic shock group were significantly higher than those in control group (P＜0.05).The serum levels of TNF-α and IL-1 in hemorrhagic hypovolemic shock group were significantly higher than those in control group(P＜0.05).The serum levels of TNF-α in MODS group were significantly higher than that in non-MODS group(P＜0.05).In hemorrhagic hypovolemic shock group, the serum levels of TNF-α in the dieds were higher than those in survival patients(P＜0.05).

Conclusion

SIRS is a main cause of MODS and often occurred after hemorrhagic hypovolemic shock.The concentration of TNF-α in serum may be related closely with prognosis after hemorrhagic hypovolemic shock.

Key words: Shock, hemorrhagic, Multiple organ dysfunction syndrome, Systemic inflammation response syndrome, Tumor necrosis factor-α, Interleukin-1
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