van Deuren M, Frieling J T, van der Ven-Jongekrijg J, Neeleman C, Russel F G, van Lier H J, Bartelink A K, van der Meer J W
Department of General Internal Medicine, University Hospital Nijmegen, The Netherlands.
Clin Infect Dis. 1998 Apr;26(4):918-23. doi: 10.1086/513933.
In 39 patients with acute meningococcal infections, the plasma concentrations of tumor necrosis factor-alpha (TNF) and its soluble receptors (sRs) TNFsR-p55 and TNFsR-p75 were measured from admission till recovery. At admission, patients with shock had significantly higher TNF, TNFsR-p55, and TNFsR-p75 values than patients without shock. In addition, during the first 24 hours, patients with shock had higher TNFsR-p75 to TNFsR-p55 ratios, indicating that in shock the increase of TNFsR-p75 exceeds that of TNFsR-p55. TNF measured more than 12 hours after admission failed to differentiate between shock and nonshock because TNF concentrations normalized within 12-24 hours. However, because concentrations of TNFsRs remained elevated for 5-6 days, at that time plasma TNFsRs still differentiated between shock and nonshock. Plasma exchange or whole blood exchange (PEBE), performed in 20 patients with shock, accelerated the decrease of plasma TNFsRs. However, because of a rebound after each PEBE session, the overall half-lives of both TNFsRs were not affected by PEBE.
在39例急性脑膜炎球菌感染患者中，从入院直至康复期间均对其血浆中的肿瘤坏死因子-α（TNF）及其可溶性受体（sRs）即TNFsR-p55和TNFsR-p75进行了测定。入院时，休克患者的TNF、TNFsR-p55和TNFsR-p75值显著高于无休克患者。此外，在最初的24小时内，休克患者的TNFsR-p75与TNFsR-p55比值更高，这表明在休克状态下，TNFsR-p75的增加超过了TNFsR-p55。入院12小时后测得的TNF无法区分休克和非休克患者，因为TNF浓度在12 - 24小时内恢复正常。然而，由于TNFsRs的浓度在5 - 6天内一直保持升高，此时血浆TNFsRs仍能区分休克和非休克患者。对20例休克患者进行了血浆置换或全血置换（PEBE），这加速了血浆TNFsRs的下降。然而，由于每次PEBE治疗后都会出现反弹，两种TNFsRs的总体半衰期并未受到PEBE的影响。
