创伤后多器官功能障碍综合征患者细胞因子对并发症发生的预测价值
Predictive value of cytokines for developing complications after polytrauma.
作者信息
Dekker Anne-Britt E, Krijnen Pieta, Schipper Inger B
机构信息
Anne-Britt E Dekker, Pieta Krijnen, Inger B Schipper, Department of Trauma Surgery, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
出版信息
World J Crit Care Med. 2016 Aug 4;5(3):187-200. doi: 10.5492/wjccm.v5.i3.187.
AIM
To investigate posttraumatic cytokine alterations and their value for predicting complications and mortality in polytraumatized patients.
METHODS
Studies on the use of specific cytokines to predict the development of complications and mortality were identified in MEDLINE, EMBASE, Web of Science and the Cochrane Library. Of included studies, relevant data were extracted and study quality was scored.
RESULTS
Forty-two studies published between 1988 and 2015 were identified, including 28 cohort studies and 14 "nested" case-control studies. Most studies investigated the cytokines interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor (TNF-α). IL-6 seems related to muliorgan dysfunction syndrome, multiorgan failure (MOF) and mortality; IL-8 appears altered in acute respiratory distress syndrome, MOF and mortality; IL-10 alterations seem to precede sepsis and MOF; and TNF-α seems related to MOF.
CONCLUSION
Cytokine secretion patterns appear to be different for patients developing complications when compared to patients with uneventful posttraumatic course. More research is needed to strengthen the evidence for clinical relevance of these cytokines.
目的
探讨创伤后细胞因子的变化及其在预测多发伤患者并发症和死亡率方面的价值。
方法
在MEDLINE、EMBASE、科学引文索引和考克兰图书馆中检索关于使用特定细胞因子预测并发症发生和死亡率的研究。在纳入的研究中，提取相关数据并对研究质量进行评分。
结果
共确定了1988年至2015年间发表的42项研究，包括28项队列研究和14项“嵌套”病例对照研究。大多数研究调查了细胞因子白细胞介素（IL）-6、IL-8、IL-10和肿瘤坏死因子（TNF-α）。IL-6似乎与多器官功能障碍综合征、多器官衰竭（MOF）和死亡率有关；IL-8在急性呼吸窘迫综合征、MOF和死亡率中似乎发生了改变；IL-10的改变似乎先于脓毒症和MOF出现；而TNF-α似乎与MOF有关。
结论
与创伤后病程平稳的患者相比，发生并发症的患者细胞因子分泌模式似乎有所不同。需要更多研究来加强这些细胞因子临床相关性的证据。
Zotero 插件