The diagnostic value of early cytokine response in patients after major trauma - preliminary report.
The diagnostic value of early cytokine response in patients after major trauma - preliminary report.
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DOI：
10.5114/ceji.2018.74871
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Słotwiński R
中科院分区：
文献类型：
--
作者：
Binkowska AM;Michalak G;Pilip S;Kopacz M;Słotwiński R
本研究旨在通过检测创伤患者外周血中细胞因子的含量，探讨创伤后早期免疫应答的机制。研究组包括32名因受伤而入住急诊科的患者。根据损伤严重度评分（ISS）的大小，将创伤患者分为两组。A组（ISS ≥ 20）13例发生并发症，5例死亡，而B组（ISS < 20）仅3例发生并发症（如呼吸衰竭和感染）。根据损伤的程度，在治疗组中观察到细胞因子浓度的显著差异。两组中IL-6和IL-1 Ra的最高水平均在住院第3小时记录，并且与B组中这些细胞因子的浓度相比，A组中这些细胞因子的浓度显著更高（p = 0.001）。在有并发症的患者中，IL-6和IL-1 Ra浓度显著高于无并发症的患者。斯皮尔曼rho相关显示IL-6（r = 0.64，p < 0.001）和IL-1 Ra（r = 0.37，p = 0.042）的基线浓度与ISS值之间存在统计学显著的正相关。从ROC曲线计算的诊断灵敏度高，发现IL-6浓度。总之，我们的研究结果表明，损伤后不久外周血中检测的细胞因子水平升高，可能与严重并发症的发生显著相关，在某些患者中可能导致死亡。监测这些细胞因子的水平，在患者的严重并发症的高风险，应常规使用。
This study was aimed to give a better understanding of the mechanisms of early immune response to trauma by assessing the concentration of cytokines in peripheral blood. The study group comprised 32 patients admitted to the Emergency Department due to injury. Depending on the magnitude of the Injury Severity Score (ISS) trauma patients were divided into two groups. In group A (ISS ≥ 20), 13 patients had complications, and five died, while in group B (ISS < 20) only three patients had complications (e.g. respiratory failure and infections). Depending on the extent of the injury, significant differences were observed in the concentrations of cytokines in the treatment groups. The highest levels of IL-6 and IL-1Ra in both groups were recorded in the third hour of hospitalisation and were considerably higher in group A compared to the concentration of these cytokines in group B (p = 0.001). In patients with complications, IL-6 and IL-1Ra concentrations were significantly higher compared to those without complications. Spearman’s rho-correlation showed a statistically significant positive correlation between baseline concentrations of IL-6 (r = 0.64, p < 0.001) and IL-1Ra (r = 0.37, p = 0.042) and the values of the ISS. A high diagnostic sensitivity calculated from ROC curves was found for IL-6 concentrations. In summary, our findings suggest that elevated levels of the cytokines tested, determined in the peripheral blood shortly after injury, may be significantly associated with the occurrence of severe complications, which in some patients can lead to death. Monitoring the levels of these cytokines in patients with a high risk of serious complications should be used routinely.
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发表时间：
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期刊：
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影响因子：
--
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