Leal Yelda A, Álvarez-Nemegyei José, Lavadores-May Ana I, Girón-Carrillo Jorge Luis, Cedillo-Rivera Roberto, Velazquez Juan R
a Cancer Population Record of Merida, Medical High Speciality Unit, Mexican Institute of Social Security (IMSS) , Merida , Yucatan , Mexico.
b Star Medica Hospital , Merida, Yucatan , Mexico.
J Matern Fetal Neonatal Med. 2019 Sep;32(17):2830-2836. doi: 10.1080/14767058.2018.1449828. Epub 2018 Mar 21.
The serum levels of some cytokines can be useful in the diagnosis of neonatal sepsis; the prognostic value of a cytokine profile has not, to our knowledge, been explored in this disease. The objective of this study is to evaluate the diagnostic value of the serum levels of cytokines IL-1, -2, -4, -5, -6, -7, -8, -10, -12, -13, and -17, TNF, IFNγ, G-CSF, GM-CSF, MCP1, and MIP1β in neonates with high risk of developing sepsis. Sepsis was evaluated in 96 high-risk neonates. We assessed cytokine levels on hospital admission and during or not during sepsis. Fifty (52%) presented sepsis (26 early and 24 late). Sepsis was associated with high levels of IL-6, IL-10, G-CSF, and MCP1 and low levels of IFNγ, early sepsis with high levels of IL-6 and G-CSF, severe sepsis with high levels of IL-6 and IL-10, while deaths or sequelae was associated with low levels of IL-4, IL-12, IFNγ, and high levels of GM-CSF. IL-6 values of ≥40.1 pg/mL were associated with the development of any type of sepsis (relative risk [RR]: 1.70; 95% confidence interval [95% CI]: 1.18-2.24; = .01), while IL-6 values of ≥44.9 pg/mL were associated with early sepsis (RR: 1.29; 95% CI: 1.29-4.56; = .01). In neonates with high risk for the development of sepsis, there is an association between levels of IL-6, IL-10, and G-SCF and the disease development/outcome.
某些细胞因子的血清水平对新生儿败血症的诊断可能有用；据我们所知，细胞因子谱在该疾病中的预后价值尚未得到探讨。本研究的目的是评估细胞因子白细胞介素-1、-2、-4、-5、-6、-7、-8、-10、-12、-13和-17、肿瘤坏死因子、干扰素γ、粒细胞集落刺激因子、粒细胞-巨噬细胞集落刺激因子、单核细胞趋化蛋白1和巨噬细胞炎性蛋白1β的血清水平对有发生败血症高风险的新生儿的诊断价值。对96例高风险新生儿进行了败血症评估。我们在入院时以及败血症发生期间或未发生期间评估了细胞因子水平。50例（52%）出现败血症（26例为早期，24例为晚期）。败血症与白细胞介素-6、白细胞介素-10、粒细胞集落刺激因子和单核细胞趋化蛋白1水平升高以及干扰素γ水平降低有关，早期败血症与白细胞介素-6和粒细胞集落刺激因子水平升高有关，严重败血症与白细胞介素-6和白细胞介素-10水平升高有关，而死亡或后遗症与白细胞介素-4、白细胞介素-12、干扰素γ水平降低以及粒细胞-巨噬细胞集落刺激因子水平升高有关。白细胞介素-6值≥40.1 pg/mL与任何类型败血症的发生相关（相对危险度[RR]：1.70；95%置信区间[95%CI]：1.18 - 2.24；P = 0.01），而白细胞介素-6值≥44.9 pg/mL与早期败血症相关（RR：1.29；95%CI：1.29 - 4.56；P = 0.01）。在有发生败血症高风险的新生儿中，白细胞介素-6、白细胞介素-10和粒细胞集落刺激因子水平与疾病的发生/转归之间存在关联。
