Persistent elevation of serum interleukin-6 in intraabdominal sepsis identifies those with prolonged length of stay
Persistent elevation of serum interleukin-6 in intraabdominal sepsis identifies those with prolonged length of stay
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DOI：
10.1016/j.jpedsurg.2004.06.015
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发表时间：
2004-10-01
影响因子：
2.4
通讯作者：
Stallion, A
中科院分区：
文献类型：
--
作者：
Latifi, SQ;O'Riordan, MA;Stallion, A
背景/目的：腹内脓毒症患者血清白介素6(IL-6)水平升高与发病率和死亡率增加有关。作者推测，在手术干预后，持续升高的IL-6能更准确地反映炎症状态，从而比单独手术前更好地预测随后的恢复时间。方法：连续19例有全身炎症反应综合征表现的腹膜炎患儿进入前瞻性研究。采用双抗体夹心酶联免疫吸附试验(ELISA)检测患者手术前后(12~24小时)血清IL-6水平。结果：术前患者血清IL-6水平为48~132,546 pg/mL。LOS从4天到60天不等，受试者分为两组，每组小于或等于11天(n=14)，大于或等于25天(n=5)。用IL-6水平大于500 pg/m L来预测LOS延长(>；11天)，术后IL-6持续升高似乎增加了LOS延长的可能性。结论：持续高于500 pg/m L的IL-6水平可能有助于识别LOS延长和发病率较高的儿童腹内脓毒症患者。这些患者的快速识别可能会为新的治疗干预措施提供支持。(C)2004 Elsevier Inc.保留所有权利。
Background/Purpose: Elevated serum interleukin-6 (IL-6) levels in patients with intraabdominal sepsis have been associated with increased morbidity and mortality. The authors hypothesized that after surgical intervention a persistent elevation of IL-6 would more accurately reflect the inflammatory state and thus predict the subsequent time to recovery better than the preoperative value alone.Methods: Nineteen consecutive children with peritonitis and manifestations of the systemic inflammatory response syndrome were enrolled prospectively. IL-6 levels were determined from pre- and postoperative serum samples (within 12 to 24 hours) by enzyme-linked immunosorbant assay (ELISA). Patient postoperative length of stay (LOS) was recorded.Results: Before surgery, patient serum IL-6 levels ranged from 48 to 132,546 pg/mL. LOS ranged from 4 to 60 days, with subjects falling into 2 groups of less than or equal to11 (n = 14) and greater than or equal to25 (n = 5) days. Using an IL-6 level greater than 500 pg/mL to predict a prolonged LOS (>11 days), a persistent elevation of IL-6 postoperatively appears to increase the likelihood of a prolonged LOS.Conclusions: Persistent IL-6 levels greater than 500 pg/mL may be useful in identifying pediatric intraabdominal sepsis patients with prolonged LOS and presumably greater morbidity. Rapid identification of these patients may allow for novel therapeutic interventions. (C) 2004 Elsevier Inc. All rights reserved.