Oda Shigeto, Hirasawa Hiroyuki, Shiga Hidetoshi, Nakanishi Kazuya, Matsuda Ken-ichi, Nakamua Masataka
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou, Chiba City, Chiba 260-8677, Japan.
Cytokine. 2005 Feb 21;29(4):169-75. doi: 10.1016/j.cyto.2004.10.010. Epub 2004 Dec 8.
This study was undertaken to investigate whether sequential measurement of blood interleukin (IL)-6 levels using chemiluminescent enzyme immunoassay (CLEIA) would be useful for the management of patients with systemic inflammatory response syndrome (SIRS)/sepsis. Forty consecutive patients with SIRS/sepsis admitted to ICU were involved in the study. Blood IL-6 level was measured everyday throughout their ICU stay at the clinical laboratory by CLEIA method. The platelet count and the sequential organ failure assessment (SOFA) score were measured consecutively. The blood IL-6 levels were elevated in SIRS/sepsis patients and were extremely high in patients with septic shock. There was no significant difference in the blood IL-6 level on admission between survivors (n=27) and non-survivors (n=13). However, the mean blood IL-6 level during ICU stay was significantly higher in the non-survivors (p<0.05). There were significant correlation between the peak IL-6 blood level and the lowest platelet count, and between the peak IL-6 blood level and the maximum SOFA score, respectively. The platelet count became lowest 2.0+/-2.0 days later on average, and the SOFA score became maximal 2.5+/-1.4 days later on average following the day when IL-6 reached its peak value. Sequential measurement of blood IL-6 levels by CLEIA is useful in evaluating the severity and in predicting the outcome of the patients with SIRS/sepsis.
本研究旨在探讨采用化学发光酶免疫分析法(CLEIA)连续测定血白细胞介素(IL)-6水平对全身炎症反应综合征(SIRS)/脓毒症患者的治疗管理是否有用。40例连续入住重症监护病房(ICU)的SIRS/脓毒症患者参与了本研究。在其入住ICU期间,每天在临床实验室采用CLEIA法测定血IL-6水平。连续测定血小板计数和序贯器官衰竭评估(SOFA)评分。SIRS/脓毒症患者的血IL-6水平升高,脓毒性休克患者的血IL-6水平极高。幸存者(n = 27)和非幸存者(n = 13)入院时的血IL-6水平无显著差异。然而,非幸存者在ICU住院期间的平均血IL-6水平显著更高(p<0.05)。血IL-6峰值水平分别与最低血小板计数以及血IL-6峰值水平与最高SOFA评分之间存在显著相关性。平均而言,血小板计数在IL-6达到峰值后2.0±2.0天降至最低,SOFA评分在IL-6达到峰值后2.5±1.4天平均达到最高。采用CLEIA法连续测定血IL-6水平有助于评估SIRS/脓毒症患者的严重程度并预测其预后。