Different proinflammatory cytokine serum pattern in neonate patients undergoing open heart surgery. Relevance of IL-8
Different proinflammatory cytokine serum pattern in neonate patients undergoing open heart surgery. Relevance of IL-8
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DOI：
10.1007/s10875-005-4081-7
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发表时间：
2005-05-01
影响因子：
9.1
通讯作者：
Alvarez-Mon, M
中科院分区：
文献类型：
--
作者：
Alcaraz, AJ;Manzano, L;Alvarez-Mon, M
本研究旨在探讨体外循环患儿血清促炎细胞因子水平的临床意义。我们将患者分为两组：8名新生儿和19名非新生儿。在胸骨切开术前、进入PICU时（术后30分钟）、手术开始后24小时和手术后3天定量测定IL-1 β、IL-6、IL-8和TNF血清水平。无论术前临床状况如何，手术心脏应激均可引起新生儿和非新生儿血清中IL-6、IL-8和TNF浓度显著增加。然而，新生儿促炎细胞因子增加的幅度，尤其是IL-8，明显大于年龄较大的儿童。此外，新生儿和非新生儿患者的血清中IL-8和TNF浓度随时间的变化模式明显不同。在新生儿和非新生儿患者中，通过肺功能障碍、正性肌力支持天数和PICU停留天数评估，IL-8水平与术后发病率之间存在显著相关性。相反，我们发现血清IL-6和TNF水平与术后临床数据之间没有关系。接受心肺转流术的新生儿和非新生儿患者表现出不同的促炎细胞因子模式。IL-8可能与小儿体外循环相关的多器官功能障碍有关。
The purpose of this work was to investigate the clinical significance of serum levels of proinflammatory cytokines in pediatric patients undergoing cardiopulmonary bypass. We divided the patients in two groups: 8 neonates, and 19 non-newborn children. IL-1 beta, IL-6, IL-8, and TNF serum levels were quantified before sternotomy, at admission to the PICU (30 min postoperatively), 24 h after the onset of surgery and 3 days after the operation. Surgical cardiac stress elicits significant increments of IL-6, IL-8 and TNF serum concentrations in both neonates and non-neonates, regardless of their preoperative clinical condition, However, in newborns the magnitude of the proinflammatory cytokine increments was, in particular with IL-8, remarkably greater than in older children. Moreover, neonate and non-neonate patients showed clearly disparate patterns of serum concentrations over time of both IL-8 and TNF. There was a marked relationship between IL-8 levels and postoperative morbidity, evaluated by pulmonary dysfunction, days on inotropic support and days of PICU stay in both neonates and non-neonates patients. In contrast, we found no relationship between serum levels of IL-6 and TNF and postoperative clinical data. Newborn and non-newborn patients undergoing cardiopulmonary bypass exhibit dissimilar patterns of proinflammatory cytokines. IL-8 might be implicated in the multiorganic dysfunction related to cardiopulmonary bypass in pediatric patients.