Plasma concentrations of cytokines, their soluble receptors, and antioxidant vitamins can predict the development of multiple organ failure in patients at risk
Plasma concentrations of cytokines, their soluble receptors, and antioxidant vitamins can predict the development of multiple organ failure in patients at risk
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DOI：
10.1097/00003246-199603000-00006
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发表时间：
1996-03-01
影响因子：
8.8
通讯作者：
Suter, PM
中科院分区：
文献类型：
--
作者：
Borrelli, E;RouxLombard, P;Suter, PM
目的：本研究的目的是：a）评估多器官功能衰竭高危患者血浆中细胞因子及其可溶性受体以及抗氧化物质的浓度; B）研究早期变化; c）检查这些元素可能的预后价值。16例多器官功能衰竭的风险。测量和主要结果：10例患者发生多器官功能衰竭，其中5例死亡。而肿瘤坏死因子-α（TNF-α）的血浆浓度只是临界较高的患者发展为多器官衰竭，TNF-可溶性受体55和75显着增加，在所有ICU天相比，患者没有进入器官衰竭。在ICU入院后的前2天内，发生多器官功能衰竭的患者的白细胞介素-6血浆浓度较高。抗氧化剂维生素C显着减少患者进入多器官功能衰竭在所有ICU天。抗氧化活性的其他生化标志物，例如维生素E、铜和锌血浆浓度，在两组之间没有差异。结论：我们的数据表明，有多器官衰竭风险的患者的抗肿瘤坏死因子活性显着增加，抗氧化防御能力下降。循环肿瘤坏死因子可溶性受体和维生素C的血浆浓度在这类患者的预测价值需要进一步评估。
Objectives: The aims of this study were: a) to evaluate plasma concentrations of cytokines and their soluble receptors, as well as antioxidant substances in patients at high risk of developing multiple organ failure; b) to investigate early change; and c) to examine the possible prognostic value of these elements.Design: Prospective analysis.Setting: Surgical intensive care unit (ICU) of a university hospital.Patients: Sixteen patients at risk for multiple organ failure.Measurements and Main Results: Ten patients developed multiple organ failure and five of them died. Whereas tumor necrosis factor-alpha (TNF-alpha) plasma concentrations were only borderline higher in patients developing multiple organ failure, TNF-soluble receptors 55 and 75 were significantly increased during all ICU days compared with patients not going into organ failure. Interleukin-6 plasma concentrations were higher in patients developing multiple organ failure during the first 2 days after ICU admission. The antioxidant vitamin C was significantly decreased in patients going into multiple organ failure during all ICU days. Other biochemical markers of antioxidant activity, such as vitamin E, copper, and zinc plasma concentrations, did not differ between the two groups.Conclusions: Our data suggest that there is a marked increase in anti-TNF activity and a decrease of antioxidant defense in patients at risk of developing multiple organ failure. The predictive value of plasma concentrations of circulating TNF-soluble receptors and vitamin C in this type of patient needs further evaluation.