[The changes and clinical significance of serum tumor necrosis factor-alpha and endothelin level in bee sting poisoning].

OBJECTIVE: To investigate the change of serum tumor necrosis factor-alpha (TNFalpha) and endothelin (ET) levels and their clinical significance in patients with bee sting poisoning. METHODS: TNFalpha and ET were measured in 97 patients with bee sting poisoning and the results were compared with those in 35 healthy controls. The 97 patients were divided into three groups i.e. mild poisoning group, moderate poisoning group and severe poisoning group and they were also divided according to prognosis into death group and survival group. RESULTS: The levels of serum TNFalpha (1.36 +/- 0.37) microg/L and ET (55.20 +/- 12.60) ng/L in the slight poisoning group increased a little, but they were not significantly different from those in the controls (1.09 +/- 0.25) microg/L and (50.90 +/- 8.80) ng/L (P > 0.05). In the moderate and severe poisoning groups the levels of serum TNFalpha (2.82 +/- 0.79) microg/L, (4.02 +/- 0.93) microg/L and plasma ET (139.30 +/- 58.80) ng/L, (210.50 +/- 86.30) ng/L were significantly higher than those in the controls (P < 0.01). The levels in the severe poisoning group were much higher than those in the moderate poisoning group and the latter much higher than those in the controls. The levels of serum TNFalpha (4.53 +/- 0.89) microg/L and plasma ET (267.50 +/- 98.70) ng/L in the death group were much higher than those in the survival group (2.40 +/- 0.82) microg/L, (107.60 +/- 57.90) ng/L (P < 0.01). The levels of serum TNFalpha were positively correlated with those of plasma ET (P < 0.01). CONCLUSIONS: TNFalpha and ET may be involved in the pathogenesis of bee sting poisoning. It is shown that the higher the levels of serum TNFalpha and plasma ET, the severer degree of the poisoning and the higher fatality rate. Serum TNFalpha and plasma ET levels may be important clinical index in judging the patients, condition and their prognosis in bee sting poisoning. It was an important clinical significance, that may be useful for medicating with antagonist and inhibitor against TNFalpha and ET to prevention and depress death rate in the patients with bee sting poisoning.

[Plasma endothelin levels in patients with multiple organ dysfunction syndrome caused by fish gall bladder poisoning].

OBJECTIVE: To investigate the correlation between the change of plasma endothelin (ET) and the occurrence and progress of multiple organ dysfunction syndrome (MODS) caused by fish gall bladder poisoning. METHODS: Plasma ET was measured in 85 patients with fish gall bladder poisoning and 30 healthy controls and comparison of the levels of plasma ET was carried out between patients groups with different severity of fish gall bladder poisoning. The relationship between plasma ET levels and enzymology as well as some biochemistry indexes in patients with fish gall bladder poisoning was then analyzed. RESULTS: Plasma ET in patients with fish gall bladder poisoning (150.5 +/- 90.5) ng/L was much higher than that in controls (52.8 +/- 9.3) ng/L. The concentration of plasma ET in slight poisoning group (61.2 +/- 13.6) ng/L increased a little, but it was not significantly different with that in controls (P > 0.05). The concentration of plasma ET was significantly higher in moderate poisoning group and severe poisoning group (162.3 +/- 82.3) ng/L and (232.6 +/- 92.7) ng/L as compared with that in the controls (P < 0.01), with the severe poisoning group much higher than the moderate poisoning group and the latter much higher than the normal. At the same time, plasma ET in MODS group and non-MODS group (210.2 +/- 98.7) ng/L and (126.3 +/- 68.3) ng/L were both notably higher than that in the controls. Furthermore plasma ET in the MODS group was much higher than that in the non-MODS (P < 0.01). It was also found that a positive correlation existed between plasma ET and creatine kinase-MB, cardiac troponin I, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen and serum creatinine (P < 0.01) and a negative correlation between plasma ET and endogenous creatinine clearance rate (P < 0.01). CONCLUSION: Plasma ET may be involved in the process of fish gall ladder poisoning and later in the progress of MODS. It was shown that the higher the level of plasma ET, the severer the degree of poisoning and the higher the fatality rate. So monitoring plasma ET level dynamically may be an important clinical index in judging the patients condition and their prognosis in fish gall bladder poisoning. Simultaneously it is useful for earlier diagnosis of fish gall bladder poisoning and alertness of MODS caused by it as well as for proper management with antagonist and inhibitor against plasma ET for prevention and cure of fish gall bladder poisoning.