Bown M J, Nicholson M L, Bell P R, Sayers R D
Department of Surgery, University of Leicester, Leicester, UK.
Eur J Vasc Endovasc Surg. 2001 Dec;22(6):485-95. doi: 10.1053/ejvs.2001.1522.
Multiple organ failure is a common mode of death following abdominal aortic aneurysm repair, particularly after rupture. Cytokines are the principal mediators of the inflammatory response to injury and high levels of circulating cytokines have been associated with poor outcome in major trauma and sepsis. Abdominal aortic aneurysm repair results in an ischaemia-reperfusion injury to the tissues distal to the site of aortic clamping. The inflammatory response in these tissues causes the release of cytokines, principally Interleukins 1-beta, 6, and 8, and Tumour Necrosis Factor alpha. If released in large enough concentrations, these cytokines may enter the circulation and gain access to organs distant to the site of initial injury. Circulating cytokines cause dysfunction of the renal, cardiovascular, respiratory, nervous and musculo-skeletal systems. The combination of these individual changes in organ function is the multiple-organ dysfunction syndrome, which may progress to multiple organ failure.
多器官功能衰竭是腹主动脉瘤修复术后常见的死亡方式，尤其是在破裂后。细胞因子是对损伤炎症反应的主要介质，循环中细胞因子水平升高与严重创伤和脓毒症的不良预后相关。腹主动脉瘤修复会导致主动脉钳夹部位远端组织的缺血再灌注损伤。这些组织中的炎症反应会导致细胞因子释放，主要是白细胞介素1-β、6和8以及肿瘤坏死因子α。如果这些细胞因子以足够高的浓度释放，它们可能进入循环并影响初始损伤部位以外的器官。循环中的细胞因子会导致肾、心血管、呼吸、神经和肌肉骨骼系统功能障碍。这些器官功能的个体变化组合起来就是多器官功能障碍综合征，可能会进展为多器官功能衰竭。
