Furunaga A, Tsuboi H, Itoh H, Kawamura T, Minami Y, Gohra H, Katoh T, Fujimura Y, Esato K
First Department of Surgery, Yamaguchi Univeristy School of Medicine, Ube, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Jun;44(6):790-4.
Systemic Inflammatory Response Syndrome (SIRS) is a new concept of entry criteria for sepsis. This concept, when applied to area of Multiple Organ Failure (MOF), is considered to be a preparatory state for MOF. To study the significance of SIRS state at cardiac surgery, we measured the body temperature, white blood cell count, respiratory rate and heart rate of 18 patients who underwent elective cardiac surgery, from the 1st post-operative day to the 7th post-operative day. We also measured Interleukin-6 and 8 (IL-6 and IL-8) to understand the relationship between the SIRS state and inflammatory cytokines just after cardiopulmonary bypass (CPB), at the 1st, 3rd and 6th postoperative day. The result was as follows: Patients with CPB more than 120 minutes have more frequency and longer duration of SIRS than patients with CPB less than 120 minutes. Serum levels of IL-8 at SIRS state were revealed statistically higher than at non-SIRS case. Duration of SIRS state was related to CPB time and serum levels of IL-6 and IL-8 just after CPB. We concluded that SIRS state is an indication for anti-cytokine therapy to prevent MOF, and it is important to shorten CPB time in order to decrease the duration of SIRS.
全身炎症反应综合征(SIRS)是脓毒症诊断标准中的一个新概念。这一概念应用于多器官功能衰竭(MOF)领域时,被认为是MOF的一种前期状态。为研究心脏手术中SIRS状态的意义,我们对18例行择期心脏手术的患者,在术后第1天至第7天测量了体温、白细胞计数、呼吸频率和心率。我们还在术后第1天、第3天和第6天测量了白细胞介素-6和8(IL-6和IL-8),以了解体外循环(CPB)刚结束时及术后SIRS状态与炎症细胞因子之间的关系。结果如下:CPB时间超过120分钟的患者,SIRS的发生频率更高、持续时间更长,相比CPB时间少于120分钟的患者。处于SIRS状态时血清IL-8水平经统计学分析高于非SIRS病例。SIRS状态的持续时间与CPB时间以及CPB刚结束时血清IL-6和IL-8水平有关。我们得出结论,SIRS状态是预防MOF进行抗细胞因子治疗的一个指征,缩短CPB时间以减少SIRS持续时间很重要。