Miller E J, Cohen A B, Matthay M A
Department of Biochemistry, University of Texas Health Center, Tyler, USA.
Crit Care Med. 1996 Sep;24(9):1448-54. doi: 10.1097/00003246-199609000-00004.
To test the hypothesis that significantly higher concentrations of interleukin-8 (IL-8) are found in the pulmonary edema fluid and plasma of patients with a septic vs. a nonseptic etiology of acute respiratory distress syndrome (ARDS).
Prospective measurement of IL-8 concentrations in previously collected edema fluid and plasma.
Adult intensive care units at a university medical center.
There were 27 patients with ARDS (16 patients with a septic etiology and nine patients with a nonseptic etiology) plus eight control patients with hydrostatic pulmonary edema.
IL-8 was present in the pulmonary edema fluid of all patients with ARDS, but the median IL-8 concentration was higher in the edema fluid of patients with ARDS associated with sepsis (84.2 ng/mL, n = 16) compared with the ARDS patients without sepsis (14.8 ng/mL, n = 11) (p < .05). In patients with cardiogenic edema, IL-8 concentration (5.0 ng/mL,n = 8, p < .05) was significantly lower than those values in patients with ARDS. Median plasma concentration of IL-8 was increased in septic individuals (1.3 ng/mL), but these concentrations were not significantly higher than in patients with a nonseptic etiology of ARDS (0.35 ng/mL) (p = .14) or those patients with cardiac failure (0.21 ng/mL).
The high concentrations of IL-8 in pulmonary edema fluid, coupled with the relatively low concentrations of IL-8 in the plasma, suggest that the lung was the primary source of IL-8 in the patients with ARDS. The markedly increased concentrations of IL-8 in the pulmonary edema fluid of patients with ARDS from sepsis suggests that this group of patients may be particularly suitable for potential trials directed at inhibiting the activity of this important chemokine.
检验以下假设，即与非脓毒症病因导致的急性呼吸窘迫综合征（ARDS）患者相比，脓毒症病因导致的ARDS患者的肺水肿液和血浆中白细胞介素-8（IL-8）浓度显著更高。
对先前采集的水肿液和血浆中的IL-8浓度进行前瞻性测量。
大学医学中心的成人重症监护病房。
27例ARDS患者（16例脓毒症病因患者和9例非脓毒症病因患者）加8例心源性肺水肿对照患者。
所有ARDS患者的肺水肿液中均存在IL-8，但与无脓毒症的ARDS患者（14.8 ng/mL，n = 11）相比，脓毒症相关ARDS患者的水肿液中IL-8浓度中位数更高（84.2 ng/mL，n = 16）（p < 0.05）。在心源性水肿患者中，IL-8浓度（5.0 ng/mL，n = 8，p < 0.05）显著低于ARDS患者。脓毒症患者的IL-8血浆浓度中位数升高（1.3 ng/mL），但这些浓度并不显著高于非脓毒症病因的ARDS患者（0.35 ng/mL）（p = 0.14）或心力衰竭患者（0.21 ng/mL）。
肺水肿液中高浓度的IL-8，加上血浆中相对较低的IL-8浓度，表明肺是ARDS患者IL-8的主要来源。脓毒症导致的ARDS患者肺水肿液中IL-8浓度显著升高，表明这组患者可能特别适合针对抑制这种重要趋化因子活性的潜在试验。
