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目的:研究严重多发伤患者血浆IL-10的变化及其与创伤严重度和临床预后的关系。方法:应用ELISA方法检测30例ISS≥16分的多发伤患者伤后血浆IL-10水平的变化,并与正常对照比较。以ISS≥25分为界把患者分成低ISS组(L-ISS)和高ISS组(H-ISS),比较两组血浆IL-10水平变化规律。另外,将16例H-ISS患者分存活、局部感染、脓毒症、SIRS、ARDS及MODS六组,比较各组间IL-10含量的变化。结果:在伤后0～21天观察期间多发伤患者血浆IL-10明显升高,伤后早期血浆IL-10水平与ISS评分呈正相关。并发SIRS、局部感染、脓毒症、MODS的患者伤后早期IL-10水平较无并发症患者、死亡患者较存活者呈不同程度升高。结论:伤后早期IL-10水平变化与患者创伤严重度和临床预后相关。
Objective: To study the changes of plasma IL-10 in patients with severe multiple trauma and its relationship with the severity of trauma and clinical prognosis. Methods: The changes of plasma IL-10 levels in 30 patients with multiple traumas with ISS≥16 were detected by ELISA and compared with the normal controls. Patients were divided into low ISS group (L-ISS) and high ISS group (H-ISS) with ISS≥25, and the changes of plasma IL-10 levels in both groups were compared. In addition, sixteen patients with H-ISS were divided into six groups according to their survival, local infection, sepsis, SIRS, ARDS and MODS. The levels of IL-10 in each group were compared. Results: IL-10 was significantly increased in patients with multiple trauma from 0 to 21 days after injury. The level of IL-10 in early post-injury group was positively correlated with ISS score. Patients with SIRS, local infection, sepsis, and MODS had higher levels of IL-10 in early post-injury patients than those without complications, and those with death were more elevated than those with survivors. Conclusion: The change of IL-10 level in the early post-traumatic period is related to the severity of trauma and clinical prognosis.