PLASMA-LEVELS OF CYTOKINES IN PRIMARY SEPTIC SHOCK IN HUMANS - CORRELATION WITH DISEASE SEVERITY

被引:185
作者
GARDLUND, B
SJOLIN, J
NILSSON, A
ROLL, M
WICKERTS, CJ
WRETLIND, B
机构
[1] UPPSALA AKAD HOSP, DEPT INFECT DIS, UPPSALA, SWEDEN
[2] DANDERYD HOSP, DEPT ANESTHESIA & INTENS CARE MED, DANDERYD, SWEDEN
[3] DANDERYD HOSP, DEPT CLIN BACTERIOL, DANDERYD, SWEDEN
关键词
D O I
10.1093/infdis/172.1.296
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Thirteen patients (median age, 20 years) with life-threatening primary septic shock (10 meningococcal, 3 pneumococcal infections) were studied prospectively. All had a short history of sepsis (less than or equal to 24 h) and no severe underlying disease. Two (15%) died. The logarithm of the initial plasma levels of tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, IL-1 receptor antagonist (ra), and plasminogen activator inhibitor (PAI)-1 correlated significantly with APACHE II scores (r(2) = .67, .57, .68, .81, and .68, respectively). The plasma levels of endotoxin, TNF-alpha, IL-1 beta, and PAI-1 decreased toward normal levels within the first 24 h of treatment, but IL-6 and IL-1ra levels remained high until clinical recovery. On admission, the molar excess of IL-1ra to IL-1 beta was >2000-fold in 11 of the 13 patients. Acute plasmapheresis in 11 of the 13 patients significantly increased the plasma clearance of TNF-alpha (P = .02).
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页码:296 / 301
页数:6
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