术后感染患者血清可溶性CD14和E┐选择素的变化意义.doc

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1、术后感染患者血清可溶性CD14和已选择素的变化意义【关键词】肿瘤坏死因子关键词:感染;抗原，CD14;E选择素;肿瘤坏死因子摘要：冃的探讨术后并发严重感染患者血清E-选择素(E-SLT)和sCD14的变化情况及其与病情预后的关系•方法采用ELISA于术前和术后测定37例手术和30例健康志愿者血清E-SI/T、sCD14及TNF-a的浓度•结果E-SLT水平在未并发感染组于术后Id开始增高，术后3d达高峰(151+12)ug・L-l,4d后开始下降，至25d接近正常水平(40±10)ug・L-l;在并发严重感染组E-SLT水平于术后Id开始增高(68±9)ug

2、539;L-l,至术后25d时仍处于高水平状态(328±54)ug・L-l.sCD14水平在未并发感染组于术后Id开始增高，4d后开始下降，至25d接近正常水平(1・03±0.16)mg&#l2539;1-1;在并发严重感染组sCD14水平丁术后Id开始增高，至术后25d仍处于高水平状态(2.63±0.82)mg・L-l.sCD14与TNF-a者间的相关系数为r=0.896,P<0.05.结论sCD14和TNF-a在术后并发严重感染的早期病理过程中起着重耍的作用，SCD14与早期感染密切相关;E-选择素可能在感染病理变化过程的后期起着重要的作用，与感染严重程度

3、相关.E-SLT和sCD14是反映术后并发感染病情变化和预后的可靠指标.Keywords:infection;antigensCD14;E-selectin;tumornecrosisfactorAbstract:AIMToinvestiga.tethecha.ngesinserumlevelsofE-selectin,solubleCDld(sCD14)andTNF-ci,aswel1astheirrelationshipbetweeninfectionandprognosisinpostop-erativepatientscomplicatedbysevereinfection.METHO

4、DSSetumE-seiectinandsCD14andTNF~aIevelsin37post-operativepatientsand30controlsonesweremeasuredbyELISAbeforeandaftefopefstion.RESULTSThelevelofE-selectioninpatientswithoutinfectionbegantoriseondlaftertheoperationandreachedthehightestlevel[(151±12)Pg・L~l]ond3・Thenitstartedtoreduceond4ti11thed25

5、,itwasclosetonormal[(40±10)ug・L-l],whileinpa-tientswithsevereinfection,thelevelofE-selectionbegantogoupdlaftertheoperation[(68±9)Ug・L-1],andre-mainedhigh[(328+54)ug・L-l]evenond25aftertheop-eration.ThelevelofsCD14inpatientswithoutinfectionbe-gantoincreasedlaftertheoperationandsta

6、rtedtoreduceond4til1thed25itbecameclosetonormal[(1.03土0.16)mg・LT];whileinpatientswithsevereinfection,thelevelofsCD14begantogoupandreachedthehighestlevel[(2.63土0.82)mg・L~1]ond25・Thecorrelationcoefficient(r)intheserumlevelsofsCDl4andTNF~ciwere0.896,P<0.05.CONCLUSIONsCD14andTNF-amaypla

7、yanimportantroleduringearlyprocessofinfectionandsCDldiscloselyre-latedtotheoccurrenceofinfection・E~selectin,isimportantinthemechanisniofpathogenesisandniightbecloselyrelatedtotheseverityofsecondaryinf