Clinical Significance Of Tumor Necrosis Factor-α And Interleukin-8 In Acute Drug Poisoning

Acute drug poisoning is one of familia emergencies andadvanced cases in emergengcy department.It usually has somefeatures: it happens suddenly, the condition changes quickly,outbreak mechanism complications diverse. There are no specialantidotes for most poisonging cases ,and therapies are absent ofunity,effectiveness,normalization.During the process of acutedrug poisoning,exogenous poisons become stimulating factor,thenprovoke immune reaction, activate inflammatory cells and releaseproinflammatory factors to kill bacterium.At the same time thebody can release sufficient antiinflammatory factors,controlinflammatory reaction. If the poisoning is severer,the balancebetweeen them is destroyed.It can initiate SIRS,CARS,MARS,eventually reduce MODS and MOF.In stress ,as the represents ofproinflammatory mediators, Tumor necrosis factor –α (TNF–α)andinterleukin-8(IL-8) are greatly released by inflammatorycells,activating other inflammatory factors and cytokines.The"waterfall"inflammatory reaction can damage cells and tissues ofthe organism. Research has proved that the concentration ofTNF-α and IL-8 are obviously increased in acute poisoning oforganphosphorous insecticides(OPI), and the more severer thecondition is ,the more higher the degree are.It usually has a highfatality rate.The result indicates:during the process of OPIpoisoning,inflammatory factors are included in the collectivepathogenesy and pathological change of poisoning.So,we assayedthe levels of TNF-α and IL-8 in acute drug poisoning cases ofvariety classes in the research ,exploringthe collective mechanismand pathological change from the aspect of cytokine,finding theobjective basis of clinic condition judgement,therapy and estimateprognosis.All acute drug poisoning cases enrolled were 42,whowere all healthy before poisoning .18 cases were poisoning ofsedativeshynotics and 24 cases were poisoning of pesticide .All thecases instantly process haemospasia.Conserve the bloodserum.Deploying radio immunoassay to determine the levels ofTNF-α and IL-8.Compare the levels of TNF-α and IL-8 betweenpoisoning group and health control group(20 cases).compare thelevels of TNF-α and IL-8 in drug poisoning cases of varietyclasses.Compare the levels of TNF-α and IL-8 of different patient'scondition of poisoning cases. Compare the levels of TNF-α andIL-8 of poisoning cases of different prognosis. We dealed all thedata of TNF-α, IL-8 and total white cell count with the method ofliner regression and correlation analysis , analyzed the data withSPSS12.0 package.The results indicated that :In acute state (<24hours)of acute drug poisoning(including hypnagogue poisoningand poisoning of pesticide ),the levels of TNF-α and IL-8 inpoisoning group were higher than those of control group ,thedifference between them was significant (P<0.01). The levels ofTNF-α and IL-8 were related to patient's condition. The moreseverer was the patient's condition ,the higher were the levels ofTNF-α and IL-8,the levels of TNF-α and IL-8 in drug poisongingcases of variety classes is no significant difference;during thepoisoning cases ,the levels of TNF-α and IL-8 in death group isevident higher then those of survive group;and the levels ofTNF-α and IL-8 were obviously related to total white cell count.Conclusion:In acute drug poisonging , exogenous poison irritatebody to produce immune reaction,release all kinds of inflammatoryfactors (including TNF-α and IL-8).As the toxicity increases,thelevels of TNF-α and IL-8 are high,PMN abnormally heighten,thereaction is loss of control,produce oxygen free radical( OFR) .OFR can damage endotheliocyte, release lysomal enzyme ,Prostaglandin , leukotriene , PAF and other inflammatoryfactors .These inflammatory factors can damage blood vesselendothelium,enhance permeability, toxic metabolites continuouslysecret ,all the changes can injury forthcoming tissue and furtherorgan, aggravate clinical syndrome including fever, circulatoryfailture,shock,ARDS and so on,induce SIRS to MODS. They arethe most important factors of aggravation in patient's condition anddeath. So TNF-α and IL-8 are the serology index to reflect theoccurance and change of acute poisoning ,they are also thereference index of estimate prognostic.we can explore activedrug and treatment to suppress the release of TNF-α,IL-8 andother inflammatory factors ,improve prognosis of patients of acutepoisoing.