Cytokine production and hospital mortality in patients with sepsis-induced stress hyperglycemia
Cytokine production and hospital mortality in patients with sepsis-induced stress hyperglycemia
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DOI：
10.1016/j.jinf.2007.05.177
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发表时间：
2007-10-01
影响因子：
28.2
通讯作者：
Gogos, Charalambos A.
中科院分区：
文献类型：
--
作者：
Leonidou, Leonidia;Mouzaki, Athanassia;Gogos, Charalambos A.
目的：探讨应激性高血糖对严重脓毒症患者主要促炎和抗炎细胞因子的产生及28d住院病死率的影响。方法：62例严重脓毒症患者入院后24 h内根据血糖水平分为应激性高血糖组(SH组，n=16)、2型糖尿病(DM组，n=27)和血糖正常组(NG组，n=19)。结果：合并应激性高血糖的脓毒症患者的死亡率高于糖尿病患者(43.7%比14.8%)和正常对照组(43.7%比5.2%)。SH组SOFA评分和IL-6、IL-10水平均高于DM组和NG组。肿瘤坏死因子-α水平也高于Dim组，但不高于NG组。三组间TGFbeta-1水平差异无统计学意义。死亡者IL-10水平较高，而IL-6、肿瘤坏死因子-α、IL-10/肿瘤坏死因子-α比值和转化生长因子β-1水平无明显差异。白介素10水平、平均空腹血糖值和年龄是影响预后的因素。结论：应激性高血糖与严重脓毒症患者细胞因子产生增加和不良临床结局有关。(C)2007年英国感染学会。爱思唯尔有限公司出版。保留所有权利。
Objectives: To investigate whether stress hyperglycemia affects the production of the main pro- and anti-inflammatory cytokines and the 28-day hospital mortality in patients with severe sepsis.Methods: The study included 62 patients with severe sepsis, divided in three groups according to their glycemic profile within 24 h after admission: patients with stress hyperglycemia (group SH, n = 16), diabetes mellitus type II (group DM, n = 27), and normal glucose levels (group NG, n = 19). The serum levels of the cytokines TNF-alpha, IL-6, IL-10 and TGFbeta-1 were measured within 24 h after admission.Results: A higher percentage of septic patients with stress hyperglycemia died compared to diabetic patients (43.7 vs. 14.8%) and group NG (43.7 vs. 5.2%). Group SH had higher SOFA score and levels of IL-6 and IL-10 than group DM and group NG. It also had higher levels of TNF-alpha than group DIM but not group NG. There was no difference in the levels of TGFbeta-1 among the three groups. Non-survivors had higher levels of IL-10, no difference was detected for IL-6, TNF-alpha, IL-10/TNF-alpha ratio and TGFbeta-1. Interleukin-10 values, mean fasting glucose values and age were found as prognostic factors associated with outcome.Conclusions: Stress hyperglycemia is associated with increased cytokine production and an adverse clinical outcome in patients with severe sepsis. (C) 2007 The British Infection Society. Published by Elsevier Ltd. All rights reserved.