Batistaki Chrysanthi, Kostopanagiotou Georgia, Myrianthefs Pavlos, Dimas Cleanthi, Matsota Paraskevi, Pandazi Aggeliki, Baltopoulos George
2nd Department of Anaesthesiology, University of Athens, School of Medicine, Attikon Hospital, 1 Rimini Str, Chaidari 12462, Athens, Greece.
Vascul Pharmacol. 2008 Feb-Mar;48(2-3):85-91. doi: 10.1016/j.vph.2007.12.003. Epub 2007 Dec 31.
Cytokines and endogenous opioids are mediators of the post traumatic inflammatory response. The aim of this study was to determine the effect of exogenous catecholamines on tumor necrosis factor alpha (TNFa), interleukin-6 (IL-6), interleukin-10 (IL-10) and beta(beta)-endorphin levels in patients with severe trauma, during the first 24 h after injury. Forty four traumatized patients with haemorrhage class III and IV were included in the study. Patients were divided in two groups: Group 1 (adrenergic, n=22) and Group 2 (non adrenergic, n=22), depending on the use of exogenous catecholamines. Blood samples were collected at 0, 2, 4 and 24 h time points. Baseline values were different between the two groups, but an altered pattern of release was observed for TNFa, IL-6, IL-10 and beta-endorphin levels in patients treated with catecholamines. ICU stay was longer for the adrenergic group, while survival after 1 month was significantly lower. Findings support an altered pattern of cytokine release during the early phase after trauma, probably due to catecholamine presence.
细胞因子和内源性阿片类物质是创伤后炎症反应的介质。本研究的目的是确定外源性儿茶酚胺对严重创伤患者伤后最初24小时内肿瘤坏死因子α（TNFα）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）和β-内啡肽水平的影响。44例III级和IV级出血的创伤患者纳入本研究。根据外源性儿茶酚胺的使用情况，患者分为两组：第1组（肾上腺素能组，n = 22）和第2组（非肾上腺素能组，n = 22）。在0、2、4和24小时时间点采集血样。两组的基线值不同，但在接受儿茶酚胺治疗的患者中，观察到TNFα、IL-6、IL-10和β-内啡肽水平的释放模式发生了改变。肾上腺素能组的重症监护病房停留时间更长，而1个月后的生存率显著更低。研究结果支持创伤后早期细胞因子释放模式的改变，可能是由于儿茶酚胺的存在。
