Rodriguez J L, Miller C G, Garner W L, Till G O, Guerrero P, Moore N P, Corridore M, Normolle D P, Smith D J, Remick D G
Department of Surgery, University of Michigan, Ann Arbor.
J Trauma. 1993 May;34(5):684-94; discussion 694-5. doi: 10.1097/00005373-199305000-00011.
Eighty-eight patients with acute thermal injury were evaluated. Forty-eight hours after injury, TNF, IL-6, and IL-8 were significantly present in the systemic circulation, lung, normal skin, and thermally injured skin. The presence of TNF, IL-6, and IL-8 proteins in the lung, normal skin, and thermally injured skin were associated with TNF, IL-6, and IL-8 mRNA upregulation. Logistic regression analysis controlling for the Abbreviated Burn Severity Index demonstrated that the presence of IL-8 in the lung was associated with early pulmonary physiologic dysfunction (p = 0.006) and nosocomial pulmonary infection (p = 0.040). We conclude that acute thermal injury initiates an early systemic, lung, and skin response involving TNF, IL-6, and IL-8. The TNF, IL-6, and IL-8 protein present in the lung and skin in response to acute thermal injury are generated locally and do not originate from the systemic cytokine pool. The lung cytokine response to acute thermal injury may initiate local organ failure.
对88例急性热损伤患者进行了评估。损伤后48小时，肿瘤坏死因子（TNF）、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）在体循环、肺、正常皮肤和热损伤皮肤中显著存在。肺、正常皮肤和热损伤皮肤中TNF、IL-6和IL-8蛋白的存在与TNF、IL-6和IL-8信使核糖核酸（mRNA）上调相关。控制简化烧伤严重程度指数的逻辑回归分析表明，肺中IL-8的存在与早期肺生理功能障碍（p = 0.006）和医院获得性肺部感染（p = 0.040）相关。我们得出结论，急性热损伤引发了涉及TNF、IL-6和IL-8的早期全身、肺和皮肤反应。急性热损伤后肺和皮肤中出现的TNF、IL-6和IL-8蛋白是局部产生的，并非源自全身细胞因子池。肺对急性热损伤的细胞因子反应可能引发局部器官衰竭。
