Scheingraber S, Bauerfeind F, Böhme J, Dralle H
Department of General Surgery, Rheinische Friedrich-Wilhelms-University, Sigmund Freud Strasse 25, D-53105, Bonn, Germany.
Am J Surg. 2001 Apr;181(4):301-8. doi: 10.1016/s0002-9610(01)00587-6.
Monitoring of peritoneal cytokine concentrations of tumor necrosis factor (TNF)-alpha was recommended for early detection of severe postoperative complications. In the present study the clinical application of cytokine monitoring was examined in the treatment course of severe peritonitis.
Nineteen patients with secondary peritonitis were followed up during 75 abdominal lavages. Serum and peritoneal interleukin (IL)-6, IL-8, and IL-10 and TNF-alpha were measured before the surgical intervention, after 1 hour, 3 hours, 6 hours, and 24 hours. Additionally, cardiorespiratory parameters, osmolarity, C-reactive protein, and total leucocyte count were recorded.
Serum and peritoneal cytokine concentrations did not correlate to each other as well as to the observed cardiorespiratory parameters. Peritoneal cytokine concentrations were 10- to 1000-fold higher to serum concentrations and showed an intermittent wash out. There were no differences in determined cytokine concentrations between survivors and nonsurvivors.
Once elevated, peritoneal cytokine measurements offer no new diagnostic or prognostic tool in abdominal lavage peritonitis treatment.
建议监测腹膜肿瘤坏死因子（TNF）-α的细胞因子浓度以早期发现严重术后并发症。在本研究中，对细胞因子监测在严重腹膜炎治疗过程中的临床应用进行了研究。
19例继发性腹膜炎患者在75次腹腔灌洗期间接受随访。在手术干预前、1小时后、3小时后、6小时后和24小时后测量血清和腹膜白细胞介素（IL）-6、IL-8、IL-10和TNF-α。此外，记录心肺参数、渗透压、C反应蛋白和白细胞总数。
血清和腹膜细胞因子浓度彼此之间以及与观察到的心肺参数均无相关性。腹膜细胞因子浓度比血清浓度高10至1000倍，并呈间歇性清除。幸存者和非幸存者之间测定的细胞因子浓度没有差异。
一旦升高，腹膜细胞因子测量在腹腔灌洗性腹膜炎治疗中并不能提供新的诊断或预后工具。
