Ostermann H, Kratz-Albers K, Mesters R M, Kiehl M, Kienast J
Department of Internal Medicine, University of Muenster, Germany.
J Infect Dis. 1997 Sep;176(3):825-8. doi: 10.1086/517313.
Plasma concentrations of interleukin-6 (IL-6) and its soluble receptor (sIL-6R) were serially determined in 32 patients with acute myeloid leukemia who developed severe sepsis (n = 19) or septic shock (n = 13) during chemotherapy-induced leukocytopenia (< or = 1 x 10(9)/L). Starting within 2 h of fever onset, IL-6 levels rose significantly over baseline in both groups to markedly higher levels in patients with evolving septic shock (medians: 372 vs. 3671 pg/mL; P < .001). Simultaneously, sIL-6R significantly decreased to lower levels in shock patients than in septic patients without hypotension (53 vs. 93 ng/mL; P = .02). This pattern was maintained throughout the observation period of up to 6 days. In patients with fatal sepsis, peak IL-6 levels were significantly higher than in survivors (P < .001), whereas minimum sIL-6R levels were markedly lower (P = .003). The reciprocal changes in circulating IL-6 and sIL-6R suggest a role for sIL-6R in modulating the effects of IL-6 during evolving sepsis in leukocytopenic patients.
在32例急性髓系白血病患者化疗诱导白细胞减少（≤1×10⁹/L）期间发生严重脓毒症（n = 19）或感染性休克（n = 13）时，连续测定其血浆白细胞介素-6（IL-6）及其可溶性受体（sIL-6R）浓度。在发热开始2小时内，两组患者的IL-6水平均显著高于基线水平，且进展为感染性休克的患者水平明显更高（中位数：372 vs. 3671 pg/mL；P <.001）。同时，休克患者的sIL-6R显著降低，低于无低血压的脓毒症患者（53 vs. 93 ng/mL；P = 0.02）。这种模式在长达6天的观察期内一直保持。在致命性脓毒症患者中，IL-6峰值水平显著高于幸存者（P <.001），而最低sIL-6R水平则明显更低（P = 0.003）。循环IL-6和sIL-6R的相反变化表明sIL-6R在白细胞减少患者脓毒症进展过程中调节IL-6作用方面发挥了作用。
