Endo S, Inada K, Inoue Y, Kuwata Y, Suzuki M, Yamashita H, Hoshi S, Yoshida M
Critical Care and Emergency Center, School of Medicine, Iwate Medical University, Morioka, Japan.
Circ Shock. 1992 Dec;38(4):264-74.
We investigated plasma levels of cytokines and endotoxin in septic shock to clarify the roles of various cytokines in this type of shock. Endotoxemia was observed in 16 of 22 septic shock patients. Plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin 1 beta (IL-1 beta) IL-2, and IL-6 were significantly higher in septic shock than in sepsis without shock. Strong correlations were noted between TNF-alpha and IL-2 levels and between IL-1 beta and IL-6 levels. Patients with high TNF-alpha and IL-2 levels also showed endotoxemia. We defined two types of septic shock from these data, i.e., endotoxin+TNF-alpha + IL-2 shock and IL-beta + IL-6 shock. In the former type, high TNF-alpha and IL-2 levels were present before the onset of shock, and shock itself was associated with endotoxemia. The second type showed simultaneous elevation of IL-1 beta and IL-6 levels at the onset of septic shock, and endotoxin was detected in some of them. These results suggest that endotoxin and extremely high levels of TNF-alpha and IL-2, or the simultaneous elevation of IL-1 beta and IL-6, are related to the onset of septic shock.
我们研究了脓毒性休克患者血浆中细胞因子和内毒素的水平，以阐明各种细胞因子在这类休克中的作用。22例脓毒性休克患者中有16例出现内毒素血症。脓毒性休克患者血浆中肿瘤坏死因子-α（TNF-α）、白细胞介素1β（IL-1β）、IL-2和IL-6的水平显著高于无休克的脓毒症患者。TNF-α与IL-2水平之间以及IL-1β与IL-6水平之间存在强相关性。TNF-α和IL-2水平高的患者也出现内毒素血症。根据这些数据，我们定义了两种类型的脓毒性休克，即内毒素+TNF-α+IL-2休克和IL-1β+IL-6休克。在前一种类型中，休克发作前TNF-α和IL-2水平较高，且休克本身与内毒素血症有关。第二种类型在脓毒性休克发作时IL-1β和IL-6水平同时升高，其中一些患者检测到内毒素。这些结果表明，内毒素和极高水平的TNF-α和IL-2，或IL-1β和IL-6的同时升高，与脓毒性休克的发作有关。
