目的　探讨肿瘤坏死因子 -a(TNF -a)、去甲肾上腺素 (NE)、内皮素 (ET)、肾上腺髓质素 (ADM)在全身炎症反应综合征 (SIRS)病理过程中的作用。方法　检测 38例不同类型的SIRS(创伤、创伤性休克、感染性休克 )患者及 12例健康对照组血浆TNF -a、NE、ET、ADM水平。结果　创伤组、创伤性休克组、感染性休克组与正常对照组血浆TNF -a、NE、ET、ADM浓度相比均明显增加 ,尤以感染性休克组为明显 (P <0 0 1)。结论　TNF -a、NE、ET、ADM可能参与SIRS的病理过程。 Objective To investigate the role of tumor necrosis factor-alpha (TNF-a), norepinephrine (NE), endothelin (ET) and adrenomedullin (ADM) in the pathogenesis of systemic inflammatory response syndrome (SIRS) Methods The levels of plasma TNF-a, NE, ET and ADM in 38 patients with SIRS (trauma, traumatic shock, septic shock) and 12 healthy controls were measured. Results The concentrations of TNF-a, NE, ET and ADM in trauma group, traumatic shock group and septic shock group were significantly higher than those in normal control group, especially in septic shock group (P <0.01). Conclusion TNF-a, NE, ET, ADM may participate in the pathological process of SIRS.