多器官功能障碍综合征患者外周血白三烯B4与p38丝裂原活化蛋白激酶的变化
唐皓 马中富 梁艳冰 翟诚顺 熊仕秋 熊艳【摘要】 目的: 探讨多器官功能障碍综合征(MODS)患者外周血白三烯B4 (LTB4)与p38丝裂原活化蛋白激酶(p38 MAPK)含量的变化及与MODS病情的关系。方法: 对26例MODS患者进行病情评分，采用酶联免疫吸附法(ELISA)检测血中LTB4与p38 MAPK含量，并与12例健康体检者进行对照。比较MODS患者MODS评分与外周血LTB4和p38 MAPK的相互关系，及MODS组死亡与存活患者的MODS评分、外周血LTB4与p38 MAPK含量。结果: MODS患者血清LTB4含量为(923.96±308.65)ng/L，明显低于健康对照组(2 453.31±400.93)ng/L(P<0.05)；MODS患者血清中p38 MAPK含量为(193.83±106.32)ng/L，与健康对照组(124.36±84.50)ng/L比较差异无显著性(P>0.05)。MODS组中死亡患者的血清LTB4含量为(444.98±206.30)ng/L，明显低于存活患者的(1 334.51±530.35)ng/L(P<0.05)；p38 MAPK含量为(272.08±207.37)ng/L，明显高于存活患者(115.59±57.99)ng/L(P<0.05)。结论: MODS晚期病理生理变化与一般炎症反应有所不同。外周血LTB4与p38 MAPK可作为MODS病情严重程度及预后判断指标。
【关键词】 多器官功能障碍综合征； 白三烯B4； p38丝裂原活化蛋白激酶
Study on the changes in serum leukotrienes B4 and p38 mitogen activated protein kinase in multiple organ dysfunction syndrome
TANG Hao, MA Zhong-fu, LIANG Yan-bing, ZHAI Cheng-shun, XIONG Shi-qiu, XIONG Yan.
Emergency Department, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong China
Corresponding author:MA Zhong-fu (Email:ma_zf@163.net)
【Abstract】 OBJECTIVE:： To investigate the changes in serum leukotrienes B4(LTB4) and p38 mitogen activated protein kinase(p38 MAPK) in multiple organ dysfunction syndrome (MODS) and to evaluate the relationship between LTB4 and p38 MAPK and clinical condition of patients with MODS. METHODS:：The clinical condition of 26 patients with MODS was evaluated with scoring system. The serum LTB4 and p38 MAPK of the said patients and that of 12 healthy individuals were determined with enzyme linked immunoadsorbent assay(ELISA). The correlation of the scores of MODS and levels of serum LTB4 and p38 MAPK was analyzed. The correlation of the scores of MODS and levels of serum LTB4 and p38 MAPK was analyzed in non-survivors and survivors. RESULTS:： The serum level of LTB4[(923.96±308.65)ng/L] was significantly lower in MODS patients compared with control group [(2 453.31±400.93)ng/L,P<0.05]. There was no significant difference in serum level of p38 MAPK between the patients with MODS [(193.83±106.32)ng/L] and control group [(124.36±84.50)ng/L, P>0.05]. There was significant difference in the serum level of LTB4 between the survivors[(1 334.51±530.35)ng/L] and non-survivors [(444.98±206.30)ng/L, P<0.05]. There were significant negative correlations between serum LTB4 and MODS scores (P<0.001). CONCLUSION:：The pathophysiological changes in later period of MODS are different from those of other common inflammatory responses. Serum LTB4 and p38 MAPK could be one of the indexes of the seriousity and prognosis on MODS. ......
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