TUMOR-NECROSIS-FACTOR-ALPHA AND INTERLEUKIN-6 PLASMA-LEVELS IN INFECTED CIRRHOTIC-PATIENTS
TUMOR-NECROSIS-FACTOR-ALPHA AND INTERLEUKIN-6 PLASMA-LEVELS IN INFECTED CIRRHOTIC-PATIENTS
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DOI：
10.1016/0016-5085(93)90361-f
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发表时间：
1993-05-01
期刊：
影响因子：
29.4
通讯作者：
DEVIERE, J
中科院分区：
文献类型：
--
作者：
BYL, B;ROUCLOUX, I;DEVIERE, J
背景：肝硬化患者肿瘤坏死因子α（TNF-α）和白细胞介素6（IL-6）的产生增加，代谢降低。本研究分析了这些细胞因子的特征模式在脓毒症在acetics.Methods：TNF-α和IL-6的血浆水平，在15天内测量从发病的acetic失代偿或脓毒症事件，比较14例感染的肝硬化患者，18例未感染的失代偿acetic患者，35例败血症患者没有肝脏疾病。结果：感染性肝硬化患者血清TNF-α和IL-6水平均显著高于非感染性肝硬化患者（P< 0.0001）和无肝硬化的败血症患者（P< 0.001）。初始IL-6血浆水平（阈值，200 pg/mL）在区分感染引起的肝硬化失代偿与其他因素引起的肝硬化失代偿方面显示出89%的特异性和100%的敏感性。TNF-α和IL-6的血浆水平在感染性败血症患者中持续升高，与其他两组相比，TNF-α和IL-6的血浆水平在感染性败血症患者中持续升高。长期暴露于TNF-α与这些患者预后不良之间的确切关系尚不清楚，但这可能代表了在脓毒症期间使用抗TNF-α抗体的独特机会。
Background:Patients with liver cirrhosis disclose both increased production and decreased metabolism of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6). The present study analyzes the characteristic pattern of these cytokines during sepsis in cirrhotics.Methods:TNF-α and IL-6 plasma levels, measured during 15 days from the onset of cirrhotic decompensation or of the septic event, were compared between 14 infected patients with liver cirrhosis, 18 uninfected decompensated cirrhotic patients, and 35 septicemic patients devoid of liver disease. Cytokines were measured using immunoassays.Results:In infected cirrhotics, initial levels of both TNF-α and IL-6 were significantly higher than in noninfected cirrhotic patients (P< 0.0001) or in septicemic patients devoid of cirrhosis (P< 0.001). Initial IL-6 plasma levels (threshold, 200 pg/mL) showed 89% specificity and 100% sensitivity in discriminating cirrhotic decompensation due to infection from that caused by other factors. TNF-α and IL-6 plasma levels remained significantly higher for many days in infected cirrhotic patients compared with the other two groups.Conclusions:Both the profoundly increased initial levels of TNF-α and IL-6 and their persistence over days after sepsis onset seem characteristic of the cirrhotic patients. The exact relationship between prolonged exposure to TNF-α and poor prognosis in these patients is unknown, but it might represent a unique opportunity for the use of anti-TNF-α antibodies during sepsis.