老年脓毒症患者细胞因子和皮质醇水平与预后的关系

目的探讨老年脓毒症患者细胞因子和糖皮质激素水平及其与脓毒症预后的关系。方法用ELISA和放射免疫的方法检测42例老年脓毒症患者治疗前和治疗1周后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、皮质醇(Cor)和促肾上腺皮质激素(ACTH)水平,同时以30例健康老年人为对照组。结果老年脓毒症患者IL-6、TNF-α和ACTH较对照组明显升高,Cor和IL-10与对照组比较无明显差异。治疗1周后,15例患者死亡,死亡组ACTHI、L-6、TNF-α水平较存活组明显增高,而CorI、L-10水平降低。结论治疗1周后,伴血清高炎症细胞因子和低Cor及IL-10的老年脓毒症患者预后较差。

Relationship of cytokines and corticosteroid levels with prognosis in elderly septic patients

Objective To explore the relationship of cytokines and glucocorticoids levels with prognosis in elderly septic patients.Methods Teh serum levels of interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）,IL-10,corticosteroid（Cor）,and adrenocorticotrophic hormone（ACTH） were measured in 42 elderly septic patients and 30 healthy elderly controls using ELISA and radioimmunoassay before and 1 week after treatments.Results Levels of IL-6,TNF-α and ACTH increased significantly in elderly septic patients compared with controls.Cor and IL-10 levels had no significant difference between the two groups.One week after treatments,15 patients died.Levels of IL-6,TNF-α and ACTH were significantly higher,but levels of Cor and IL-10 significantly lower in dead patients than in survival patients.Conclusion Elderly septic patients with higher inflammatory cytokines and lower Cor and IL-10 levels after treatment have poor prognosis.