Different expression of cytokines in survivors and non-survivors from MODS following cardiovascular surgery.
Different expression of cytokines in survivors and non-survivors from MODS following cardiovascular surgery.
复制标题
心血管手术后 MODS 幸存者和非幸存者细胞因子的表达不同。
DOI：
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发表时间：
2003
影响因子：
4.2
通讯作者：
E. Czeslick
中科院分区：
文献类型：
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作者：
A. Sablotzki;M. Dehne;I. Friedrich;S. Grond;B. Zickmann;J. Mühling;R. Silber;E. Czeslick
目的
心脏搭桥术后常伴有全身炎症反应综合征（SIRS）或多器官功能障碍综合征（MODS）等病理生理变化。在本研究中，我们调查了心脏直视手术后早期MODS幸存者和非幸存者的促炎细胞因子和抗炎细胞因子的血浆水平。
设计
前瞻性临床研究。
设置
一所大学的心胸重症监护室。
方法
对16例Apache II评分>24分且心肌血运重建后有两个或两个以上器官功能障碍的成年男性患者，在术后前4天测定细胞因子（IL-6、IL-8、IL-10、IL-18和TGF-β）和降钙素原（PCT）水平。
主要结果
所有促炎细胞因子，除了IL-6，在MODS的非幸存者中显著升高，在术后的前两天达到峰值。免疫抑制性细胞因子的血浆水平显示组间无差异。
结论
我们的研究结果表明，在体外循环手术后MODS的幸存者和非幸存者中，促炎细胞因子的表达不同。除Apache-II评分外，IL-8、IL-18和PCT可作为心脏术后器官功能障碍患者预后的指标。
OBJECTIVE
Cardiopulmonary bypass is often associated with pathophysiological changes in form of systemic inflammatory response syndrome (SIRS) or multiple organ dysfunction syndrome (MODS). In the present study, we investigated plasma levels of pro- and anti-inflammatory cytokines in survivors and non-survivors from MODS in the early postoperative course following open heart surgery.
DESIGN
Prospective clinical study.
SETTING
A University Cardiothoracic Intensive Care Unit.
METHODS
Levels of cytokines (IL-6, IL-8, IL-10, IL-18, and TGF- ) and procalcitonin (PCT) were measured at the first four postoperative days in 16 adult male patients with an Apache II-score >24 and two or more organ dysfunctions after myocardial revascularization.
MAIN RESULTS
All pro-inflammatory cytokines, except for IL-6, were significantly elevated in non-survivors from MODS, with peak values at the first two postoperative days. The plasma levels of immunoinhibitory cytokines showed no differences between the groups.
CONCLUSIONS
The results of our study show a different expression of pro-inflammatory cytokines in survivors and non-survivors from MODS following operations with extracorporeal circulation. In addition to Apache-II score, especially IL-8, IL-18, and PCT may be used as parameters for the prognosis of patients with organ dysfunctions after cardiac surgery.