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Correlation between soluble tumor necrosis factor receptor and protein catabolism and its value in predicting prognosis in critically ill patients
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF EMERGENCY MEDICINE
- Issue:
- 3
- DOI:
- 10.3760/j.issn:1671-0282.2005.03.003
- Key Word:
- 危重病;肿瘤坏死因子受体;应激激素;蛋白质;分解代谢
Abstract： 目的探讨肿瘤坏死因子-α(TNF-α)及其可溶性受体I(sTNFRⅠ)、应激激素与危重病蛋白质高分解代谢的关系及其在预后判断中的价值.方法危重病组(n=50)按随访结果分为存活组和死亡组,同时设立正常对照组(n=15).检测研究对象血中TNF-α、sTNFRⅠ、应激激素及营养指标水平,并进行相关性分析.结果⑴危重病患者sTNFRⅠ、TNF-α、皮质醇、胰高血糖素均显著高于正常对照组(P值均小于0.01),而前白蛋白(PA)、转铁蛋白(TF)、白蛋白(ALB)均显著低于正常对照组(P值均小于0.001).(2)危重病死亡组APACHEⅡ评分、sTNFRⅠ、皮质醇、胰高血糖素均高于存活组(P＜0.05),但TNF-α、PA、TF、ALB水平,两组间差异无显著性.⑶各指标的相关性分析结果:①APACHEⅡ评分与sTNFRⅠ、TNF-α、皮质醇、胰高血糖素水平相关(P＜0.05),而与营养指标无关.② sTNFRⅠ与PA、TF、ALB水平均相关(P＜0.05),TNF-α仅与PA水平相关(P＜0.05),皮质醇、胰高血糖素与上述蛋白水平均无相关性.③sTNFRⅠ、TNF-α均与皮质醇、胰高血糖素水平相关(P＜0.05)⑷以危重病预后为因变量的Logistic回归分析示仅APACHEⅡ评分和sTNFRⅠ仍独立与危重病预后相关.结论 TNF-α、sTNFRⅠ介导了危重病蛋白质高分解代谢,且sTNFRⅠ可独立预测危重病预后.
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