Stensballe J, Christiansen M, Tønnesen E, Espersen K, Lippert F K, Rasmussen L S
Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, Copenhagen University Hospital, 9 Blegdamsvej, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2009 Apr;53(4):515-21. doi: 10.1111/j.1399-6576.2008.01801.x.
Trauma has previously been shown to influence interleukin (IL)-6 and IL-10 levels, but the association of injury severity and mortality with IL-6 and IL-10 responses in the early phase of accidental trauma remains to be investigated. We wished to describe serum levels of IL-6 and IL-10 in the first 24 h after trauma and to assess the relationship with severity of injury and mortality.
Prospective, descriptive cohort study in a Level 1 trauma centre, Copenhagen, Denmark. We included 265 consecutive adult trauma patients admitted directly from the accident scene during an 18-month period. Serum levels of IL-6 and IL-10 were measured upon arrival and at 6, 12, and 24 h after admittance using an enzyme-linked immunosorbent assay. Correlation analysis was used to assess the relationship between Injury Severity Score (ISS) and levels of IL-6 and IL-10. Analysis of variance was used to describe the IL-6 and IL-10 concentrations in relation to 30-day mortality in a mixed-effect model repeated measures analysis.
Mortality was 10.9% (29/265) at 30 days. A significant increase of both IL-6 and IL-10 concentrations was found over time, and a significant correlation was found between ISS and the levels of both IL-6 and IL-10 at all sampling points. Serum concentrations of IL-6 and IL-10 were significantly higher in patients not surviving 30 days (P<0.0001).
The early systemic inflammatory response measured as IL-6 and IL-10 in serum is correlated with injury severity and 30-day mortality following trauma.
先前研究表明创伤会影响白细胞介素(IL)-6和IL-10水平,但在意外创伤早期,损伤严重程度及死亡率与IL-6和IL-10反应之间的关联仍有待研究。我们希望描述创伤后24小时内血清IL-6和IL-10水平,并评估其与损伤严重程度及死亡率的关系。
在丹麦哥本哈根的一级创伤中心进行前瞻性描述性队列研究。我们纳入了在18个月期间直接从事故现场收治的265例连续成年创伤患者。入院时及入院后6、12和24小时使用酶联免疫吸附测定法测量血清IL-6和IL-10水平。采用相关性分析评估损伤严重程度评分(ISS)与IL-6和IL-10水平之间的关系。在混合效应模型重复测量分析中,采用方差分析描述与30天死亡率相关的IL-6和IL-10浓度。
30天时死亡率为10.9%(29/265)。随着时间推移,IL-6和IL-10浓度均显著升高,且在所有采样点,ISS与IL-6和IL-10水平之间均存在显著相关性。30天内未存活患者的血清IL-6和IL-10浓度显著更高(P<0.0001)。
血清中以IL-6和IL-10衡量的早期全身炎症反应与创伤后的损伤严重程度及30天死亡率相关。