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目的探讨全身炎症反应综合征(SIRS)患儿血清TNF-α及其可溶性受体-Ⅰ(sTNFR-Ⅰ)变化及临床意义。方法应用双抗体夹心ELISA法检测SIRS患儿(SIRS组)及健康儿童(对照组)的血清TNF-α及sTNFR-Ⅰ,计算sTNFR-Ⅰ/TNF-α比值。结果SIRS组血清TNF-α、sTNFR-Ⅰ高于对照组,其危重期高于缓解期(P均<0.01);SIRS组与对照组、危重期与缓解期sTNFR-Ⅰ/TNF-α比值比较均无统计学差异;患儿病情恶化时其比值低于入院时及缓解时(P均<0.05)。SIRS患儿危重评分与TNF-α、sTNFR-Ⅰ水平呈负相关(P<0.01),与sTNFR-Ⅰ/TNF-α比值无相关性(P>0.05);病情恶化患儿危重评分与TNF-α、sTNFR-Ⅰ水平均呈负相关(P<0.01),与sTN-FR-Ⅰ/TNF-α比值呈正相关(P<0.05)。结论血清TNFα-、sTNFR-Ⅰ及sTNFR-Ⅰ/TNF-α比值变化可较好地反映SIRS患儿的病情改变,对预测其病情变化有重要意义。
Objective To investigate the changes of serum TNF-α and soluble receptor-Ⅰ (sTNFR-Ⅰ) in children with systemic inflammatory response syndrome (SIRS) and its clinical significance. Methods The serum levels of TNF-α and sTNFR-Ⅰ in children with SIRS (SIRS group) and healthy children (control group) were detected by double antibody sandwich ELISA and the ratio of sTNFR-Ⅰ / TNF-α was calculated. Results Serum levels of TNF-α and sTNFR-Ⅰ in SIRS group were significantly higher than those in control group (P <0.01), and the ratio of sTNFR-Ⅰ / TNF-α in SIRS group and control group was significantly higher than that in control group No significant difference was found between the two groups. The odds of worsening in children were lower than those on admission and remission (all P <0.05). There was no significant correlation between the critical score of SIRS and the levels of TNF-αand sTNFR-Ⅰ (P <0.01), but not with the ratio of sTNFR-Ⅰ / TNF-α (P> 0.05) α and sTNFR-Ⅰ, and had a positive correlation with sTN-FR-Ⅰ / TNF-α (P <0.05). Conclusion The changes of serum TNFα, sTNFR-Ⅰ and sTNFR-Ⅰ / TNF-α ratio can reflect the changes of SIRS in children. It is important to predict the changes of the disease.