Fu Yue, Xiao Qi-ming, Wang Tong, Chen Xin-he, Ai Yu-hang
Department of Emergency, the Xiangya Hospital of Central South University, Changsha 410008, Hunan, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2006 Nov;18(11):691-4.
To evaluate the significance of changes in the serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) in patients with multiple organ dysfunction syndrome (MODS) regarding its diagnosis and judgement of severity and outcome, and to investigate the correlations between the levels of tumor necrosis factor-alpha (TNF-alpha), sFas and sFasL.
Enzyme linked immunoadsorbent assay (ELISA) was used in the determination of serum sFas, sFasL and TNF-alpha in 36 patients with MODS. Thirty-two non SIRS patients and 20 healthy individuals comprised the control groups. The acute physiology and chronic health evaluation III (APACHE III) scoring system and modified MODS scoring system were used to assess patients' clinical severity. The differences of sFas and sFasL levels between MODS group and control groups and between survival and dead patients were observed. The correlations between sFas, sFasL and TNF-alpha levels and severity of MODS and the correlations between the TNF-alpha levels and the levels of sFas and sFasL were also observed.
The serum levels of sFas, sFasL and TNF-alpha in patients with MODS were significantly higher than those in controls (P<0.05 or P<0.01), and were associated with severity of the disease (all P<0.01) . The sFas and sFasL levels were found to be significantly higher in the patients who eventually died as compared to those in the patients who survived (both P<0.05). Positive correlations were noted between the TNF-alpha levels and the levels of sFas and sFasL(both P<0.01). The serum levels of sFas and sFasL were elevated with the increase of the number of failure organs in MODS patients.
The serum levels of sFas and sFasL may serve as diagnostic and prognostic indicators for MODS. TNF-alpha may help enhance the expression of Fas/FasL system.
评估可溶性Fas（sFas）和可溶性Fas配体（sFasL）血清水平变化在多器官功能障碍综合征（MODS）患者诊断、病情严重程度判断及预后方面的意义，并探讨肿瘤坏死因子-α（TNF-α）水平与sFas、sFasL水平之间的相关性。
采用酶联免疫吸附测定法（ELISA）检测36例MODS患者血清sFas、sFasL和TNF-α水平。32例非全身炎症反应综合征（SIRS）患者和20例健康个体作为对照组。采用急性生理与慢性健康状况评价III（APACHE III）评分系统和改良的MODS评分系统评估患者临床严重程度。观察MODS组与对照组之间以及存活患者与死亡患者之间sFas和sFasL水平的差异。还观察sFas、sFasL和TNF-α水平与MODS严重程度之间的相关性以及TNF-α水平与sFas、sFasL水平之间的相关性。
MODS患者血清sFas、sFasL和TNF-α水平显著高于对照组（P<0.05或P<0.01），且与疾病严重程度相关（均P<0.01）。最终死亡患者的sFas和sFasL水平显著高于存活患者（均P<0.05）。TNF-α水平与sFas、sFasL水平呈正相关（均P<0.01）。MODS患者血清sFas和sFasL水平随衰竭器官数量增加而升高。
血清sFas和sFasL水平可作为MODS的诊断和预后指标。TNF-α可能有助于增强Fas/FasL系统的表达。
