Kragsbjerg P, Holmberg H, Vikerfors T
Department of Infectious Diseases, Orebro Medical Center Hospital, Sweden.
Scand J Infect Dis. 1996;28(4):391-8. doi: 10.3109/00365549609037926.
Cytokines play a major role in the pathophysiology of sepsis and septic shock. Using enzyme immunoassays the acute serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), granulocyte-colony stimulating factor (G-CSF), interleukin-8 (IL-8), and leukemia inhibitory factor (LIF) were investigated in 90 patients with positive blood cultures and clinical signs of infection. In 27 patients samples were obtained on admission, after 1, 4, 12, 18, and 24 h, and then daily. The acute serum levels of IL-6, TNF-alpha, G-CSF, and IL-8 were significantly higher among patients with severe sepsis. Patients with Gram-negative infection had significantly higher levels of TNF-alpha on admission than did patients with Gram-positive infections (p = 0.0008). The levels of IL-6, G-CSF and, to some extent, TNF-alpha decreased rapidly in survivors within the first 24 h of admission to hospital and institution of treatment. LIF was detected in 8/90 in both survivors and nonsurvivors.
细胞因子在脓毒症和脓毒性休克的病理生理学中起主要作用。采用酶免疫测定法，对90例血培养阳性且有感染临床体征的患者，检测其血清中白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、粒细胞集落刺激因子（G-CSF）、白细胞介素-8（IL-8）和白血病抑制因子（LIF）的急性水平。27例患者在入院时、1小时、4小时、12小时、18小时和24小时后采集样本，之后每天采集。严重脓毒症患者的IL-6、TNF-α、G-CSF和IL-8的急性血清水平显著更高。革兰阴性菌感染患者入院时的TNF-α水平显著高于革兰阳性菌感染患者（p = 0.0008）。在入院及开始治疗后的头24小时内，幸存者体内的IL-6、G-CSF以及一定程度上的TNF-α水平迅速下降。在90例患者中有8例幸存者和非幸存者检测到了LIF。
