Arranz E, Blanco-Quirós A, Solís P, Garrote J A
Department of Pediatrics and Immunology, University of Valladolid, Spain.
Pediatr Allergy Immunol. 1997 Nov;8(4):194-9. doi: 10.1111/j.1399-3038.1997.tb00160.x.
Meningococcal sepsis is a good model to study the dynamic response of cytokines and other soluble factors in vivo in the early stages of the disease. Levels of soluble CD14, interleukin-6 (IL-6), IL-6 receptor (IL-6R), and C-reactive protein (CRP) have been measured in plasma from 26 children with septic shock (nine of whom had disseminated intravascular coagulation) and from ten control children. All samples were collected at the onset, before treatment, and, when possible, 24 and 48 hours later. At admission, patients had significantly higher levels of IL-6 (p < 0.001) and CRP (p < 0.001), and lower levels of IL-6R (p < 0.005) than normal controls. After 24 hours, there was a significant increase of sCD24 (p < 0.05) and CRP (p < 0.001). Although IL-6 showed a progressive decline since the onset, its levels were always higher than controls. There was an inverse correlation between IL-6 and both IL-6R (p < 0.001) and CRP (p < 0.001), probably due to the later increase of CRP. Nevertheless, sCD14 did not correlate with IL-6 levels. We have confirmed the finding of IL-6 as a sensitive and reliable inflammatory marker in septic shock. Moreover, the ratio IL-6/IL-6R may have a prognostic value, given a putative role of IL-6R in modulating the effects of IL-6 in meningococcal sepsis.
脑膜炎球菌性败血症是研究疾病早期体内细胞因子和其他可溶性因子动态反应的良好模型。已对26名感染性休克儿童（其中9名患有弥散性血管内凝血）和10名对照儿童血浆中的可溶性CD14、白细胞介素-6（IL-6）、IL-6受体（IL-6R）和C反应蛋白（CRP）水平进行了测定。所有样本均在发病时、治疗前采集，如有可能，在24小时和48小时后采集。入院时，患者的IL-6水平（p < 0.001）和CRP水平（p < 0.001）显著高于正常对照组，而IL-6R水平（p < 0.005）低于正常对照组。24小时后，可溶性CD24（sCD24）（p < 0.05）和CRP（p < 0.001）显著升高。虽然自发病以来IL-6呈逐渐下降趋势，但其水平始终高于对照组。IL-6与IL-6R（p < 0.001）和CRP（p < 0.001）均呈负相关，这可能是由于CRP随后升高所致。然而，sCD14与IL-6水平无相关性。我们证实了IL-6作为感染性休克中敏感且可靠的炎症标志物这一发现。此外，鉴于IL-6R在调节脑膜炎球菌性败血症中IL-6的作用，IL-6/IL-6R比值可能具有预后价值。
