Grabosch A, Rokos H
Department of Plastic Surgery, Hospital Am Urban, Berlin, Germany.
Burns. 1992 Apr;18(2):113-6. doi: 10.1016/0305-4179(92)90006-g.
Serum neopterin levels have been determined retrospectively in 22 patients with burn injuries. Neopterin, which is produced by monocytes/macrophages following stimulation by interferons, is regarded as a marker for the activation of the cellular immune response. In most patients neopterin levels were initially in the normal range. All patients had their first operation and skin transplantation during the first week; mean neopterin levels increased significantly thereafter. Further skin transplantations or infections did not significantly influence the elevated neopterin level. This result may be due to continuous stimulation of the cellular immune system, as indicated by the elevated neopterin levels during most of the follow-up. In four low risk patients, neopterin levels always remained in the normal range. Two patients with inhalation trauma showed highly elevated neopterin levels (30-70 nmol/l) already upon admission and for 3 days thereafter. No correlation of neopterin levels with the burned body surface area was observed. However, mean serum neopterin levels were higher in the group of non-survivors (five patients) compared to survivors during the first 2 weeks after the trauma; rising neopterin levels were observed during the last 5 days before death. Although elevated neopterin levels could not be attributed either to the burn itself or to later events, the cellular immune system of burned patients was shown to be highly activated.
对22例烧伤患者的血清新蝶呤水平进行了回顾性测定。新蝶呤由单核细胞/巨噬细胞在干扰素刺激后产生，被视为细胞免疫反应激活的标志物。大多数患者的新蝶呤水平最初处于正常范围。所有患者在第一周内进行了首次手术和皮肤移植；此后平均新蝶呤水平显著升高。进一步的皮肤移植或感染并未显著影响升高的新蝶呤水平。这一结果可能是由于细胞免疫系统受到持续刺激，如在大部分随访期间新蝶呤水平升高所示。在4例低风险患者中，新蝶呤水平始终保持在正常范围内。2例吸入性创伤患者入院时及此后3天新蝶呤水平就已大幅升高（30 - 70 nmol/l）。未观察到新蝶呤水平与烧伤体表面积之间存在相关性。然而，在创伤后的前2周内，非存活者组（5例患者）的平均血清新蝶呤水平高于存活者；在死亡前的最后5天观察到新蝶呤水平不断上升。尽管升高的新蝶呤水平既不能归因于烧伤本身，也不能归因于后期事件，但烧伤患者的细胞免疫系统显示出高度激活。
