Holzheimer R G, Steinmetz W
Med. Faculty Martin-Luther University Halle Wittenberg, Wallbergstr. 15a, D-82054 Sauerlach, Germany.
Eur J Med Res. 2000 Aug 18;5(8):347-55.
There is a lack of knowledge on the concentrations of cytokines and growth factors in wound healing. The objective was to characterize the pattern of local-tissue and systemic peri-and postoperative dynamics of cytokines and growth factors in a clinical model of a controlled and comparable operative plastic surgery trauma.
Prospective clinical study. -
A University Department of Surgery.
28 patients undergoing an elective reduction mammoplasty.
IL-6, IL-8, sTNFR-1 and TGF-beta levels in plasma and wound fluid.
Levels of cytokines increased only moderately in plasma. Cytokine levels in wound fluid were several fold higher. IL-6 in the wound fluid peaked at 7 hours after the operation (271 +/- 135.8 pg/ml); IL-8 after 4 hours (11 +/- 9.4 ng/ml); sTNFR-1 at the second postoperative day (11.1 +/- 3.4 ng/ml). TGF-beta decreased at the first (15.2 +/- 8.6 ng/ml) and second (11.7 +/- 5.0 ng/ml) postoperative day.
Wound cytokine and growth factor levels are markedly higher than the systemic ones indicating a compartmentalization of the immune response. Cytokines peaked at different time points, probably reflecting the influx of inflammatory cells into the wound and the phase of wound healing. Further studies are necessary to clarify the mechanism of cytokine release in normal postoperative wounds before therapeutic use can be developed.
目前对于伤口愈合过程中细胞因子和生长因子的浓度缺乏了解。本研究旨在刻画在可控且具有可比性的整形手术创伤临床模型中，细胞因子和生长因子在局部组织及全身围手术期和术后的动态变化模式。
前瞻性临床研究。
一所大学的外科系。
28例行择期乳房缩小成形术的患者。
血浆和伤口渗出液中白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、可溶性肿瘤坏死因子受体-1（sTNFR-1）和转化生长因子-β（TGF-β）的水平。
血浆中细胞因子水平仅适度升高。伤口渗出液中的细胞因子水平高出数倍。伤口渗出液中的IL-6在术后7小时达到峰值（271±135.8皮克/毫升）；IL-8在术后4小时达到峰值（11±9.4纳克/毫升）；sTNFR-1在术后第二天达到峰值（11.1±3.4纳克/毫升）。TGF-β在术后第一天（15.2±8.6纳克/毫升）和第二天（11.7±5.0纳克/毫升）下降。
伤口中的细胞因子和生长因子水平明显高于全身水平，表明免疫反应存在分隔现象。细胞因子在不同时间点达到峰值，这可能反映了炎症细胞流入伤口以及伤口愈合的阶段。在开发治疗用途之前，有必要进行进一步研究以阐明正常术后伤口中细胞因子释放的机制。
