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目的 :探讨SIRS期血浆肿瘤坏死因子 α (TNF α)、内皮素 (ET)、超氧化物歧化酶(SOD)含量变化及与肾功能损害的临床意义。方法 :采用放射免疫法 ,对 32例符合SIRS标准的患者 ,在出现SIRS表现即刻、 2 4h、 72h血浆TNF α、ET、SOD含量进行测定 ,并与正常对照组15例比较 ,同时用Spect肾动态显象和肾彩色多普勒做肾血流测定。结果 :发生MODS时肾衰组TNF α、ET、SOD均高于无肾衰组和正常对照组 ,(P <0 0 5 ,P <0 0 1)核素 ,多普勒肾动态显像变化早于传统肾生化指标。结论 :动态监测血浆炎性介质水平与肾血流动力学变化 ,对预测肾功损害程度、转归密切相关。核素、彩色多普勒肾血流显象是评价MODS时肾功能、肾血流状态的一种简便、无创、有效的诊断方法
Objective: To investigate the changes of plasma tumor necrosis factor α (TNF α), endothelin (ET) and superoxide dismutase (SOD) levels in SIRS and their clinical significance. Methods: Thirty-two SIRS-eligible patients underwent radioimmunoassay. Plasma SIRS, TNFα, ET and SOD were measured immediately after SIRS, and compared with 15 normal subjects. Dynamic imaging and renal color Doppler renal blood flow measurement. Results: The levels of TNFα, ET and SOD in renal failure group were significantly higher than those in non-renal failure group and normal control group (P <0.05, P <0.01) Before the traditional kidney biochemical indicators. Conclusions: Dynamic monitoring of plasma inflammatory mediators and renal hemodynamic changes are closely related to predicting the degree of renal damage. Radionuclide, color Doppler renal blood flow imaging is a simple, noninvasive and effective diagnostic method to evaluate renal function and renal blood flow status during MODS