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严重脓毒症患者的细胞因子水平的动态变化。

Serial cytokine levels in patients with severe sepsis.

机构信息

Division of Pulmonary Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, #222, Maijin Rd. Anle Chiu, Keelung 204, Taiwan, ROC.

出版信息

Inflamm Res. 2009 Jul;58(7):385-93. doi: 10.1007/s00011-009-0003-0. Epub 2009 Mar 5.

Abstract

OBJECTIVE AND DESIGN

The serial or dynamic changes of cytokine levels in severely septic patients, between shock and no shock, survivors and non-survivors are still unclear.

METHODS

Seventy-six patients with severe sepsis were enrolled to our study. Plasma levels of interferon-gamma, interleukin (IL)-6, IL-10, IL-12 and transforming growth factor-beta1 from day 1 to day 7 were determined.

RESULTS

IL-6 level in non-survivors was higher than that in survivors on day 1. IL-10 level in non-survivors was higher than that in survivors on day 1, 2, and 3. IL-6 level in shock patients was higher than that in non-shock patients on day 1, 2, 6 and 7. IL-10 level in shock patients was higher than that in non-shock patients from day 1 to day 7. Plasma time-course curves of IL-6 and IL-10 were different between survivors and non-survivors. Plasma time-course curve of IL-6 was different between patients with shock and without shock. Regression analysis found that IL-6 was correlated with IL-10 and shock. IL-10 was correlated with IL-6 and mortality.

CONCLUSION

IL-6 and IL-10 were the key cytokines in the pathogenesis of severe sepsis. IL-6 was comparatively more associated with septic shock and IL-10 was comparatively more associated with mortality.

摘要

目的和设计

严重脓毒症患者在休克和非休克、存活和非存活患者之间细胞因子水平的连续或动态变化仍不清楚。

方法

纳入 76 例严重脓毒症患者。从第 1 天到第 7 天测定干扰素-γ、白细胞介素(IL)-6、IL-10、IL-12 和转化生长因子-β1 的血浆水平。

结果

非存活组患者的 IL-6 水平在第 1 天高于存活组。非存活组患者的 IL-10 水平在第 1、2 和 3 天高于存活组。休克患者的 IL-6 水平在第 1、2、6 和 7 天高于非休克患者。休克患者的 IL-10 水平在第 1 天到第 7 天高于非休克患者。IL-6 和 IL-10 的血浆时间过程曲线在存活组和非存活组之间不同。IL-6 的血浆时间过程曲线在休克患者和非休克患者之间不同。回归分析发现,IL-6 与 IL-10 和休克相关。IL-10 与 IL-6 和死亡率相关。

结论

IL-6 和 IL-10 是严重脓毒症发病机制中的关键细胞因子。IL-6 与脓毒性休克的相关性更高,而 IL-10 与死亡率的相关性更高。

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