Gołąbek-Dropiewska Katarzyna, Pawłowska Justyna, Witkowski Jacek, Lasek Jerzy, Marks Wojciech, Stasiak Mariusz, Jaskólski Dawid, Kawecka Aleksandra, Łuczkiewicz Piotr, Baczkowski Bogusław
2nd Department of Orthopaedics and Kinetic Organ Traumatology, Medical University of Gdańsk, Poland.
Chair and Department of Physiopathology, Medical University of Gdańsk, Poland.
Cent Eur J Immunol. 2018;43(1):42-49. doi: 10.5114/ceji.2018.74872. Epub 2018 Mar 30.
Severe trauma causes damage to the protective barriers of the organism, and thus activates immunological reaction. Among substances secreted during this process pro-inflammatory cytokines are of high importance.
Severe trauma causing multiple injuries is more likely to lead to particularly intensive inflammatory reaction, which can sometimes lead to serious complications, even life-threatening. The aim of the study is to determine those parameters which may serve as predictors of infectious complications and to enable estimation of the patient's immunological status before the decision to introduce elective procedures.
The study population included patients with multiple trauma treated in the Department of Trauma Surgery of the Medical University of Gdańsk. The severity of injuries was evaluated with commonly used numerical scales (Revised Trauma Score - RTS, Injury Severity Score - ISS, Glasgow Coma Scale - GCS). Blood samples were collected on the first, second, and fifth day after injury. Evaluated parameters: C-reactive protein (CRP), the level of cytokines: IL-8, IL-1β, IL-6, TNF, IL-12p70, and IL-10. Control population: individuals without injury.
Evaluation of IL-6, IL-8, and CRP levels in patients with multiple trauma in the early period after injury (2-3 days) could be considered as a predictor of delayed infection (5-10 days). CRP level, being cheap and commonly accessible, can be used in clinical practice enabling identification of patients at higher risk of infectious complications and introduction of appropriate treatment and prevention. The analysis of the mentioned parameters may contribute to choosing an appropriate management strategy, including "timing" depending on the patient's biological status.
严重创伤会破坏机体的保护屏障,从而激活免疫反应。在此过程中分泌的物质中,促炎细胞因子至关重要。
导致多处受伤的严重创伤更有可能引发特别强烈的炎症反应,有时甚至会导致严重并发症,甚至危及生命。本研究的目的是确定那些可作为感染并发症预测指标的参数,并在决定实施择期手术前能够评估患者的免疫状态。
研究人群包括在格但斯克医科大学创伤外科接受治疗的多发伤患者。采用常用的数值量表(修订创伤评分 - RTS、损伤严重程度评分 - ISS、格拉斯哥昏迷量表 - GCS)评估损伤的严重程度。在受伤后的第一天、第二天和第五天采集血样。评估参数:C反应蛋白(CRP)、细胞因子水平:IL-8、IL-1β、IL-6、TNF、IL-12p70和IL-10。对照组:未受伤个体。
在受伤后早期(2 - 3天)对多发伤患者的IL-6、IL-8和CRP水平进行评估,可被视为延迟感染(5 - 10天)的预测指标。CRP水平低廉且易于获取,可用于临床实践,以识别感染并发症风险较高的患者,并采取适当的治疗和预防措施。对上述参数的分析可能有助于选择合适的管理策略,包括根据患者的生物学状态确定“时机”。