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目的探讨孕产妇甲流感患者血清中DD、PCT、LTB4和TNF-α各细胞因子在甲流感感染中的作用。方法采用酶联免疫吸附法(ELISA)测定24例甲流感孕产妇患者血清二聚体(DD)、血清降钙素原(PCT)、白三烯B4(LTB4)、肿瘤坏死因子-α(TNF-α)的水平。结果 TNF-α在重症组于入院第1天时达峰值,随着抗病毒的有效治疗,其值逐渐下降;危重组第1天明显升高,未见其出现峰值,而是呈现逐渐上升的趋势。重症组、危重症组比较,在同一时间点TNF-α水平与疾病严重程度并非一定成正比。重症组、危重症组PCT于入院第1天时达峰值,以后迅速下降,逐渐恢复趋于正常水平,但仍明显高于对照组(P<0.01);DD于入院第1天达峰值,第3天和第5天有所下降,但一直处于较高水平(P<0.05);LTB4一直处于较高水平,在第3天、第5天明显升高,第5天最高。血清TNF-α与PCT、LTB4存在一定程度的正相关,但与DD相关性差异无统计学意义。结论孕产妇甲流感患者血清中DD、PCT及LTB4与TNF-α的指标的动态检测,我们发现这些指标与甲流感重症、危重症的发生有密切联系,故可将它们联合起来诊断和干预孕产妇甲流感重症、危重,从而降低其发生率和病死率。
Objective To investigate the role of serum cytokines DD, PCT, LTB4 and TNF-α in the screening of influenza A in pregnant women with influenza A virus. Methods Serum dimers (DD), serum procalcitonin (PCT), leukotriene B4 (LTB4) and tumor necrosis factor-α (TNF) were measured by enzyme-linked immunosorbent assay (ELISA) -α) levels. Results The level of TNF-α peaked on the first day of hospitalization in severe group, and gradually decreased with the effective treatment of antiviral therapy. The level of TNF-αin the severe group increased significantly on the first day, but no peak appeared, but gradually increased . Severe group, critically ill group, at the same time point TNF-α level and the severity of the disease is not necessarily proportional. In severe group and critically ill group, PCT peaked on the first day of hospital admission, then decreased rapidly and gradually recovered to normal level, but still significantly higher than that of the control group (P <0.01); DD peaked on the first day of admission, (P <0.05). LTB4 was always at a high level. On the third day, the level of LTB4 increased significantly on the fifth day and reached the highest on the fifth day. Serum TNF-α and PCT, LTB4 there is a certain degree of positive correlation, but no significant difference with the DD. Conclusions The dynamic detection of DD, PCT, LTB4 and TNF-α in sera from patients with flu during pregnancy and childbirth, we found that these indicators are closely related to the occurrence of critically ill and critically ill patients with influenza A, so they can be combined to diagnose and interfere with pregnancy Maternal influenza A severe, critically ill, thereby reducing the incidence and mortality.