Liu Xiaojun, Wang Gang, Zhang Tao
Department of Cardiac Surgery, Qingdao Fuwai Cardiovascular Hospital, Qingdao, Shandong, China.
Clin Hemorheol Microcirc. 2020;76(1):1-7. doi: 10.3233/CH-190674.
To investigate the changes in the levels of plasm interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), matrix metalloproteinase-9 (MMP-9) and endotoxins in patients with acute aortic dissection (AAD).
55 AAD patients who were admitted and scheduled to undergo emergency surgery in our hospital from January 2017 to July 2017 were selected and retrospectively analyzed. They were divided into the survival group (n = 40) and the death group (n = 15). The levels of plasma IL-6, TNF-α, CRP, MMP-9 and endotoxins at admission and at 6 h, 12 h and 24 h after admission (T0, T1, T2 and T3) were measured, and the correlations of inflammatory cytokines with endotoxins were analyzed.
At T1, T2 and T3, the levels of inflammatory cytokines and endotoxins were increased. The levels of plasma IL-6, TNF-α, CRP, MMP-9 and endotoxins in the death group were significantly higher than those in the survival group at each time point (p < 0.05 in all comparisons). Neutrophil and platelet counts in the death group were higher than those in the survival group (p < 0.05). Correlation analyses indicated that the levels of IL-6, TNF-α, CRP and MMP-9 were positively correlated with the level of endotoxin.
Patients with AAD are often accompanied by systemic inflammatory responses, with inflammation-related cytokines (IL-6, TNF-α, CRP and MMP-9) and endotoxins levels significantly elevated. Combined monitoring of dynamic changes in inflammatory cytokines and endotoxins, as well as early interventions, has important clinical implications for evaluating the prognosis of AAD and reducing mortality.
探讨急性主动脉夹层（AAD）患者血浆白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、基质金属蛋白酶-9（MMP-9）及内毒素水平的变化。
选取2017年1月至2017年7月在我院收治并计划行急诊手术的55例AAD患者进行回顾性分析。将其分为生存组（n = 40）和死亡组（n = 15）。测定入院时及入院后6小时、12小时和24小时（T0、T1、T2和T3）血浆IL-6、TNF-α、CRP、MMP-9及内毒素水平，并分析炎性细胞因子与内毒素的相关性。
在T1、T2和T3时，炎性细胞因子和内毒素水平升高。死亡组各时间点血浆IL-6、TNF-α、CRP、MMP-9及内毒素水平均显著高于生存组（所有比较p < 0.05）。死亡组中性粒细胞和血小板计数高于生存组（p < 0.05）。相关性分析表明，IL-6、TNF-α、CRP和MMP-9水平与内毒素水平呈正相关。
AAD患者常伴有全身炎症反应，炎症相关细胞因子（IL-6、TNF-α、CRP和MMP-9）及内毒素水平显著升高。联合监测炎性细胞因子和内毒素的动态变化以及早期干预，对评估AAD预后和降低死亡率具有重要临床意义。
