[Dynamic changes in serum levels of cytokines in patients with systemic inflammatory response syndrome].
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).


CONCLUSIONS
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.
Mei
Xue
X
Department of Emergency, Chaoyang Hospital, Capital University of Medical Science, Beijing 100020, China.
Li
Chun-sheng
CS
Wang
Shuo
S
D000368:Aged; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D005260:Female; D006684:HLA-DR Antigens / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism; D011379:Prognosis; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*
D016207:Cytokines; D006684:HLA-DR Antigens