Patel R T, Deen K I, Youngs D, Warwick J, Keighley M R
University Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK.
Br J Surg. 1994 Sep;81(9):1306-8. doi: 10.1002/bjs.1800810914.
Levels of plasma cytokines and circulating endotoxin were assessed in 41 patients with severe intra-abdominal sepsis. Comparison was made with the Acute Physiology And Chronic Health Evaluation (APACHE) II scoring system. Blood samples were taken within 24 h of onset of the sepsis syndrome and at serial times thereafter. Increased levels of interleukin (IL) 6 (range 50-25,500 pg/ml) were detectable in all patients with sepsis. Eighteen of the 19 deaths were attributable to sepsis and higher levels of IL-6 at the onset of the sepsis syndrome correlated with a poor outcome. The sensitivity of IL-6 concentration in predicting mortality was 86.4 per cent with a specificity of 78.9 per cent and an overall correct classification rate of 82.9 per cent. IL-6 level was a better predictor than APACHE II score (sensitivity 72.7 per cent, specificity 57.9 per cent, correct classification rate 65.9 per cent). Levels of tumour necrosis factor alpha, IL-1 beta and endotoxin did not correlate with mortality rate. Plasma IL-6 concentrations may help in planning future strategies to decrease the mortality rate associated with sepsis.
对41例严重腹腔内脓毒症患者的血浆细胞因子水平和循环内毒素进行了评估。并与急性生理与慢性健康状况评分系统（APACHE）II进行了比较。在脓毒症综合征发作后24小时内及之后的连续时间采集血样。所有脓毒症患者均可检测到白细胞介素（IL）-6水平升高（范围为50-25,500 pg/ml）。19例死亡患者中有18例归因于脓毒症，脓毒症综合征发作时较高的IL-6水平与不良预后相关。IL-6浓度预测死亡率的敏感性为86.4%，特异性为78.9%，总体正确分类率为82.9%。IL-6水平比APACHE II评分（敏感性72.7%，特异性57.9%，正确分类率65.9%）是更好的预测指标。肿瘤坏死因子α、IL-1β和内毒素水平与死亡率无关。血浆IL-6浓度可能有助于规划未来降低脓毒症相关死亡率的策略。
