Circulatory resuscitation with left ventricular assist device support reduces interleukins 6 and 8 levels
Circulatory resuscitation with left ventricular assist device support reduces interleukins 6 and 8 levels
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DOI：
10.1016/s0003-4975(96)01117-4
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发表时间：
1997-04-01
影响因子：
4.6
通讯作者：
Oz, MC
中科院分区：
文献类型：
--
作者：
Goldstein, DJ;Moazami, N;Oz, MC
背景。据报道，严重充血性心力衰竭患者的肿瘤坏死因子血清水平升高。本研究旨在表征急性循环衰竭患者的细胞因子谱。方法。在接受左心室辅助装置放置前 24 小时内以及机械辅助至少 30 天后或移植前从 14 名连续患者抽取血液，检测白细胞介素 6、白细胞介素 8 和肿瘤坏死因子-α 的水平。 结果。 14 名患者中，11 名患者 (79%) 的白细胞介素 6 水平升高，10 名患者 (71%) 的白细胞介素 8 水平升高，2 名患者 (14%) 的肿瘤坏死因子水平升高。血流动力学恢复后，白细胞介素 6 水平从 33.6 +/- 9 pg/mL 下降至 11.3 +/- 4 pg/mL (p = 0.05)，白细胞介素 8 水平从 122 +/- 34 pg/mL 下降至 19.7 +/- 8 pg/mL (p = 0.005)。肿瘤坏死因子-α水平没有显着变化；它们与 2 名左心室辅助装置接受者的感染有关，并在左心室辅助装置支持后恢复正常。所有患者在机械支持后循环休克均得到缓解，终末器官功能参数有所改善。结论。左心室辅助装置置入治疗的循环性休克与感染性休克类似的促炎症反应有关。血流动力学恢复后细胞因子血清水平下降表明这些细胞因子可能是组织损伤的标志物并可能调节心脏功能障碍。 (C) 1997 年，胸外科医师协会。
Background. Elevated tumor necrosis factor serum levels have been reported in patients with severe congestive heart failure. This study was designed to characterize the cytokine profile in patients with acute circulatory collapse.Methods. Blood drawn from 14 consecutive patients within 24 hours before undergoing left ventricular assist device placement and after at least 30 days of mechanical assistance or before transplantation was assayed for levels of interleukin 6, interleukin 8, and tumor necrosis factor-alpha.Results. Interleukin 6 level was elevated in 11 (79%), interleukin 8 in 10 (71%), and tumor necrosis factor in 2 (14%) of the 14 patients. After hemodynamic recovery, interleukin 6 levels decreased from 33.6 +/- 9 pg/mL to 11.3 +/- 4 pg/mL (p = 0.05) and interleukin 8 levels decreased from 122 +/- 34 pg/mL to 19.7 +/- 8 pg/mL (p = 0.005). Tumor necrosis factor-alpha levels did not vary significantly; they were associated with infection in 2 left ventricular assist device recipients and normalized after left ventricular assist device support. All patients had resolution of circulatory shock after mechanical support and had improvement in parameters of end-organ function.Conclusions. Circulatory shock treated with left ventricular assist device placement is associated with a proinflammatory response similar to that seen in septic shock. The decrease in cytokine serum levels that follows hemodynamic recovery suggests that these cytokines may be markers of tissue damage and may modulate cardiac dysfunction. (C) 1997 by The Society of Thoracic Surgeons.