Prognostic predictive values of serum cytochrome c, cytokines, and other laboratory measurements in acute encephalopathy with multiple organ failure
Prognostic predictive values of serum cytochrome c, cytokines, and other laboratory measurements in acute encephalopathy with multiple organ failure
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DOI：
10.1136/adc.2005.078436
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发表时间：
2006-06-01
影响因子：
5.2
通讯作者：
Suzuki, H
中科院分区：
文献类型：
--
作者：
Hosoya, M;Kawasaki, Y;Suzuki, H
目的：评价急性脑病合并多器官功能衰竭患者发病初期血清细胞色素c、细胞因子及其他实验室指标对预后的预测价值。方法：除常规实验室检查外，对29例急性脑病患者早期采集的血清细胞色素c(细胞色素c)和细胞因子(炎症标志物)浓度进行检测。结果：细胞色素c、肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、可溶性肿瘤坏死因子受体1(sTNF-R1)和天门冬氨酸氨基转移酶(AST)的早期浓度均较高，且与患者预后密切相关。血清细胞色素c(>；45 ng/ml)、sTNF-R1(>；2000 pg/ml)、天冬氨酸转氨酶(>；58IU/dl)、IL-6(>；60 pg/ml)和肿瘤坏死因子-α(>；15 pg/ml)的高浓度预测预后不良(后遗症和死亡)的比例分别为93%、79%、82%、77%和60%。其特异度分别为100%、89%、83%、100%和100%。结论：血清细胞色素c是早期预测重型脑病发生的最敏感、最特异的指标。结果表明，这一标记物可能被用来指导关于开始初始治疗和进一步重症监护的决定。
Aims: To evaluate the prognostic predictive values of cytochrome c, cytokines, and other laboratory measurements in serum collected during neurological onset in acute encephalopathy with multiple organ failure.Methods: In addition to general laboratory examinations, the concentrations of cytochrome c (apoptosis marker) and cytokines (inflammatory markers) were measured in serum samples collected at the initial phase in 29 patients with acute encephalopathy. The obtained values were evaluated as predictors for the development of severe encephalopathy.Results: Cytochrome c, tumour necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), soluble TNF-receptor 1 (sTNF-R1), and aspartate aminotransferase (AST) concentrations at the initial phase were high and correlated well with patient outcome. High concentrations of serum cytochrome c (> 45 ng/ml), sTNF-R1 (> 2000 pg/ml), AST (> 58 IU/dl), IL-6 (> 60 pg/ml), and TNF-alpha (> 15 pg/ml) predicted an unfavourable prognosis ( sequelae and death) at 93%, 79%, 82%, 77%, and 60%, respectively. The specificity of those markers was 100%, 89%, 83%, 100%, and 100%, respectively.Conclusions: Serum cytochrome c is the most sensitive and specific predictor for the development of severe encephalopathy at the initial phase. Results suggest that this marker might be used to guide decisions regarding the start of the initial treatment and further intensive care.