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[Dynamic changes in serum levels of cytokines in patients with systemic inflammatory response syndrome]
Xue Mei1, Chun-sheng Li, Shuo Wang
1Department of Emergency, Chaoyang Hospital, Capital University of Medical Science, Beijing 100020, China.
Objective:
To study the dynamic changes in serum levels of inflammatory and anti-inflammatory cytokines and the effect on prognosis in patients with systemic inflammatory response syndrome (SIRS).
Methods:
One hundred and thirteen patients were divided into two groups according to diagnostic criteria of SIRS: SIRS group (n=78) and non-SIRS group (n=35). SIRS group was divided into two subgroups according to the prognosis: survival group (n=37) and death group (n=41). Another 30 healthy adults served as normal controls. Concentrations of inflammatory, anti-inflammatory cytokines in serum and human leukocyte antigen-DR (HLA-DR) expression intensity of monocytes were measured.
Results:
The serum levels of inflammatory cytokines in patients of SIRS and death groups were obviously higher compared with non-SIRS and survival group (all P<0.01), and they increased in quantity progressively along with the progress and seriousness of the existing diseases. Anti-inflammatory cytokines and the HLA-DR expression intensity of monocyte in SIRS and death group declined progressively, especially the value of HLA-DR was lower compared with that of non-SIRS and survival group (all P<0.01). There were significant correlations among the IL-6, HLA-DR and APACHE II (R(2)=0.811, APACHE II=(0.180 x IL - 6) - (0.868 x HLA - DR) + 22.265, F=49.290, P<0.01).
Conclusion:
The progressive increase in inflammatory cytokines and the progressive declination of anti-inflammatory cytokine and HLA-DR expression intensity of monocyte in patients with SIRS indicate a poor prognosis.
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