Changes in serum and cerebrospinal fluid cytokines in response to non-neurological surgery: an observational study.
Changes in serum and cerebrospinal fluid cytokines in response to non-neurological surgery: an observational study.
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DOI：
10.1186/1742-2094-9-242
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发表时间：
2012-10-24
影响因子：
9.3
通讯作者：
Wass CE
中科院分区：
文献类型：
--
作者：
Bromander S;Anckarsäter R;Kristiansson M;Blennow K;Zetterberg H;Anckarsäter H;Wass CE
手术会在体内引发炎症反应，这可以通过外周细胞因子和皮质醇水平的增加来观察。然而，很少有人知道围手术期的中枢神经系统（CNS）的炎症变化。我们的目的是比较手术前后血清和脑脊液（CSF）中的炎症标志物，并评估其与血脑屏障（BBB）完整性指标的相关性。35例在脊髓麻醉下接受膝关节成形术的患者在手术前、手术后和手术后早晨采集CSF和血清样本。在所有三个时间点评估血清和CSF中的细胞因子和白蛋白以及CSF中的皮质醇。术后血清和CSF中细胞因子和皮质醇水平均显著升高（P <0.01），且CSF的升高幅度大于血清。10名患者的细胞因子反应增加，CSF/血清白蛋白比值显著升高（P <0.01），其中5名患者的白蛋白比值在病理范围内（>11.8）。术后血清和CSF中细胞因子水平无相关性，但CSF中IL-2、IL-10和IL-13与白蛋白比值之间存在强相关性（P <0.05）。CNS中的细胞因子增加显著大于血清中的细胞因子增加，表明CNS炎症系统在外周手术期间被激活，并且可能与外周体中的炎症系统分开调节。CSF细胞因子增加可能表明对创伤的敏感性，并与BBB大分子渗透性有关。
Surgery launches an inflammatory reaction in the body, as seen through increased peripheral levels of cytokines and cortisol. However, less is known about perioperative inflammatory changes in the central nervous system (CNS). Our aim was to compare inflammatory markers in serum and cerebrospinal fluid (CSF) before and after surgery and evaluate their association with measures of blood–brain barrier (BBB) integrity. Thirty-five patients undergoing knee arthroplastic surgery with spinal anesthesia had CSF and serum samples drawn before, after and on the morning following surgery. Cytokines and albumin in serum and CSF and cortisol in CSF were assessed at all three points. Cytokines and cortisol were significantly increased in serum and CSF after surgery (Ps <0.01) and CSF increases were greater than in serum. Ten individuals had an increased cytokine response and significantly higher CSF/serum albumin ratios (Ps <0.01), five of whom had albumin ratios in the pathological range (>11.8). Serum and CSF levels of cytokines were unrelated, but there were strong correlations between CSF IL-2, IL-10 and IL-13, and albumin ratios (Ps <0.05) following surgery. Cytokine increases in the CNS were substantially greater than in serum, indicating that the CNS inflammatory system is activated during peripheral surgery and may be regulated separately from that in the peripheral body. CSF cytokine increase may indicate sensitivity to trauma and is linked to BBB macromolecular permeability.
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影响因子：
3.9
作者：
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通讯作者：
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影响因子：
15.9
作者：
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