Cytokines, nitrite/nitrate, soluble tumor necrosis factor receptors, and procalcitonin concentrations: Comparisons in patients with septic shock, cardiogenic shock, and bacterial pneumonia
Cytokines, nitrite/nitrate, soluble tumor necrosis factor receptors, and procalcitonin concentrations: Comparisons in patients with septic shock, cardiogenic shock, and bacterial pneumonia
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DOI：
10.1097/00003246-199704000-00009
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发表时间：
1997-04-01
影响因子：
8.8
通讯作者：
Heumann, D
中科院分区：
文献类型：
--
作者：
deWerra, I;Jaccard, C;Heumann, D
目的：测定并比较脓毒性休克、心源性休克和非休克性肺炎患者血浆中肿瘤坏死因子(TNF)- α、白细胞介素(IL)-6、可溶性TNF受体、亚硝酸盐/硝酸盐（NO2-/NO3-）和降钙素原的浓度；并评估这些介质在判定脓毒性休克患者中的预测价值。设计：队列研究，比较正常志愿者（对照组）和感染性休克、心源性休克和细菌性肺炎患者。环境：一个重症监护病房、一个急诊室和三个研究实验室之间的合作研究。患者：对15例脓毒性休克患者（休克期和恢复期）、7例休克期心源性休克患者和7例重症细菌性肺炎患者在入院第1天的不同时间测量介质。干预措施：在疾病过程中的不同时间采集血液样本。测量和主要结果：tnf - α值在感染性休克急性期最高（感染性休克期间为53 ~ 131 pg/mL），而细菌性肺炎患者的浓度为中等（32 pg/mL）。心源性休克患者的tnf - α浓度正常。急性感染性休克患者IL-6浓度最高（85 ~ 385 pg/mL）。然而，与tnf - α浓度相反，细菌性肺炎患者的IL-6浓度正常，心源性休克患者的IL-6浓度升高（78 pg/mL）。与对照组相比，可溶性TNF受体在所有三组中均升高，其中感染性休克患者升高幅度最大。脓毒性休克患者NO2-/NO3-浓度最高（72 ~ 140 mM）
Objectives: To determine and compare the respective concentrations of tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, soluble TNF receptors, nitrite/nitrate (NO2-/NO3-), and procalcitonin in the plasma of patients with septic shock, cardiogenic shock, and bac terial pneumonia without shock; and to assess the predictive Value of these mediators in defining patients with septic shock.Design: Cohort study, comparing normal volunteers (controls) and patients with septic shock, cardiogenic shock, and bacterial pneumonia.Setting: A collaborative study among an intensive care unit, an emergency room, and three research laboratories.Patients: Mediators were measured at various times in 15 patients with septic shock (during the shock phase and during the recovery phase), in seven patients with cardiogenic shock during the shock phase, and in seven patients with severe bacterial pneu monia on day 1 of admission. interventions: Blood samples were collected at various times during the course of the disease.Measurements and Main Results: TNF-alpha values were highest in the acute phase of septic shock (53 to 131 pg/mL during septic shock), while patients with bacterial pneumonia had intermediate concentrations (32 pg/mL). TNF-alpha concentrations were normal in patients with cardiogenic shock. IL-6 concentrations were highest in patients with acute septic shock (85 to 385 pg/mL). However, in contrast to TNF-alpha concentrations, IL-6 concentrations were normal in patients with bacterial pneumonia and increased in patients with cardiogenic shock (78 pg/mL). Soluble TNF receptors were increased in all three groups vs, controls, with the highest increase in patients with septic shock. NO2-/NO3- concentrations were highest (72 to 140 mM) in patients with septic shock, and were