关键词: 感染;抗原，CD14;E选择素;肿瘤坏死因子

    摘 要:目的 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-SLT、sCD14及TNF-α的浓度. 结果 E-SLT水平在未并发感染组于术后1d开始增高，术后3d达高峰(151±12)μg·L-1 ，4d后开始下降，至25d接近正常水平(40±10)μg·L-1 ;在并发严重感染组E-SLT水平于术后1d开始增高(68±9)μg·L-1 ，至术后25d时仍处于高水平状态(328±54)μg·L-1 .sCD14水平在未并发感染组于术后1d开始增高，4d后开始下降，至25d接近正常水平(1.03±0.16)mg·L-1 ;在并发严重感染组sCD14水平于术后1d开始增高，至术后25d仍处于高水平状态(2.63±0.82)mg·L-1 .sCD14与TNF-α者间的相关系数为r=0.896，P<0.05. 结论 sCD14和TNF-α在术后并发严重感染的早期病理过程中起着重要的作用，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.

    Serum E┐selectin and soluble CD14in postoperative pateints complicated by severe infection

    DAI Yuan-Bing，YANG Yong，SHI De

    Department of General Surgery，College of Clinical Medicine，Chongqing University Medical Sciences，Chongqing400016，China

    Keywords:infection;antigens，CD14;E-selectin;tumor necrosis factor

    Abstract:AIM To investigate the changes in serum levels of E-selectin，soluble CD14(sCD14)and TNF-α，as well as their relationship between infection and prognosis in postop-erative patients complicated by severe infection.METHODS Serum E-selectin and sCD14and TNF-αlevels in37post-operative patients and30controls ones were measured by ELISA before and after operation.RESULTS The level of E-selection in patients without infection began to rise on d1after the operation and reached the hightest level [(151±12)μg·L-1 ]on d3.Then it started to reduce on d4till the d25 ......