title: [The changes and clinical significance of serum tumor necrosis factor-alpha and endothelin level in bee sting poisoning].
abstract: 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.
authors.affiliation: Department of Internal Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China. xcy68@yahoo.com.cn
authors.forename: Cheng-yun
authors.initials: CY
authors.lastname: Xia
authors.forename: Jing-guo
authors.initials: JG
authors.lastname: Zhou
authors.forename: Guo-yuan
authors.initials: GY
authors.lastname: Zhang
authors.forename: Jian-ping
authors.initials: JP
authors.lastname: Xie
authors.forename: Xin-jun
authors.initials: XJ
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001514:Bee Venoms / Q000506:poisoning*; D016232:Endothelins / Q000097:blood*; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000097:blood* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011863:Radioimmunoassay; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D001514:Bee Venoms; D016232:Endothelins; D014409:Tumor Necrosis Factor-alpha