Post-traumatic mortality rates are still very high and show an increasing tendency. Early identification of patients at high risk of severe complications has a significant impact on treatment outcomes. The aim of the study was to better understand the early pathological inflammatory response to injury and infection, and to determine the usefulness of the assessment of TNF-α and sTNFR1 concentrations in the peripheral blood as early indicators of severe post-traumatic complications. The study was carried out in a group of 51 patients after trauma, treated in the ED, including 32 patients who met the inclusion criteria for immunological analysis. Patients were divided into two groups using the ISS scale (A ISS ≥ 20, B ISS < 20). The highest TNF-α and sTNFR1 concentrations in both groups were recorded at admission and were significantly higher in group A compared to group B (A vs. B TNF-α 2.46 pg/ml vs. 1.78 pg/ml; sTNFR1 1667.5 pg/ml vs. 875.2 p < 0.005). The concentration of sTNFR1 in patients with severe complications was significantly higher compared to patients without complications and preceded clinical symptoms of complications (C+ vs. C- 1561.5 pg/ml vs. 930.6 pg/ml, p < 0,005). The high diagnostic sensitivity calculated from the ROC curves was found for the concentrations of both cytokines: TNF-α (AUC = 0.91, p = 0.004) and sTNFR1 (AUC = 0.86, p = 0.011). Elevated levels of sTNFR1, determined in the peripheral blood shortly after injury, are significantly associated with the occurrence of later complications, which in some patients lead to death. In contrast, high levels of TNF-α shortly after injury are associated with mortality.

中文翻译：

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可溶性肿瘤坏死因子受体I是严重创伤患者中复杂临床结局的有希望的早期指标。

创伤后死亡率仍然很高，并且呈上升趋势。早期识别出发生严重并发症的高风险患者对治疗结果具有重大影响。该研究的目的是更好地了解对损伤和感染的早期病理性炎症反应，并确定评估外周血中TNF-α和sTNFR1浓度作为严重创伤后并发症的早期指标的有用性。这项研究在51名创伤后患者中进行，该患者在ED中接受治疗，其中32名符合免疫分析纳入标准的患者。使用ISS量表将患者分为两组（A ISS≥20，B ISS <20）。入院时两组均记录到最高的TNF-α和sTNFR1浓度，并且与B组相比，A组显着更高（A vs.BTNF-α2.46 pg / ml对1.78 pg / ml; sTNFR1 1667.5 pg / ml对比875.2 p <0.005）。具有严重并发症的患者中的sTNFR1的浓度明显高于没有并发症和有并发症的临床症状的患者（C + vs. C- 1561.5 pg / ml与930.6 pg / ml，p <0.005）。对于两种细胞因子：TNF-α（AUC = 0.91，p = 0.004）和sTNFR1（AUC = 0.86，p = 0.011）的浓度，发现从ROC曲线计算出的高诊断灵敏度。受伤后不久在外周血中测定的sTNFR1水平升高与以后并发症的发生显着相关，后者在某些患者中会导致死亡。