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目的:探讨感染性休克患者血清肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-10(IL-10)的变化和采用低剂量琥珀酸氢化可的松治疗对细胞因子的影响。方法:采集感染性休克患者不同时段的外周血,用酶增敏免疫测定法(EASIA)测定血清中TNF-α、IL-1β、IL-10的浓度,并和脓毒血症患者及健康组进行比较;对感染性休克患者进行随机分组,分为低剂量琥珀酸氢化可的松治疗组和对照组,比较两组之间TNF-α、IL-10、IL-1β的差异。结果:感染性休克患者的TNF-α和IL-10的浓度较脓毒血症患者和健康组显著增高(P<0.05),且脓毒血症患者的浓度显著高于健康对照组(P<0.05);IL-1β在感染性休克患者和脓毒血症患者中的浓度明显高于健康组(P<0.05),但在感染性休克患者和脓毒血症患者之间无显著性差异(P>0.05);采用低剂量琥珀酸氢化可的松治疗后,感染性休克患者的TNF-α浓度明显下降(P<0.05),IL-1β的浓度不受影响(P>0.05),IL-10则显著升高(P<0.05)。结论:血清细胞因子TNF-α、IL-1β、IL-10参与了感染性休克的发生、发展过程。低剂量琥珀酸氢化可的松治疗感染性休克时对细胞因子具有一定的调控作用。
Objective: To investigate the changes of serum tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β) and interleukin-10 (IL-10) in patients with septic shock and with low-dose succinate hydrogenation Effect of Pine Therapy on Cytokines. Methods: Peripheral blood samples from patients with septic shock were collected at different time points. Serum concentrations of TNF-α, IL-1β and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA) The patients with septic shock were randomly divided into low dose of hydrocortisone succinate group and control group. The differences of TNF-α, IL-10 and IL-1β between the two groups were compared. Results: The levels of TNF-α and IL-10 in septic shock patients were significantly higher than those in sepsis patients and healthy subjects (P <0.05), and the concentrations of sepsis patients were significantly higher than those in healthy controls (P < 0.05). The concentration of IL-1β in patients with septic shock and septic patients was significantly higher than that in healthy controls (P <0.05), but there was no significant difference between patients with septic shock and those with septic shock (P> 0.05). After low-dose hydrocortisone succinate treatment, the concentration of TNF-α in septic shock patients was significantly decreased (P <0.05), the concentration of IL-1β was not affected (P> 0.05) 10 was significantly higher (P <0.05). Conclusion: Serum cytokines TNF-α, IL-1β and IL-10 are involved in the pathogenesis and development of septic shock. Low doses of hydrocortisone succinate in the treatment of septic shock on cytokines have a certain regulatory role.