THE VARIETY AND THE
MEANINGS OF TNF-α, IL-1β, IL-6 IN CRITICAL CHILDREN OF SIRS
Wang LJ, Liu CF
Pediatric Department,
Second Clinical College, China Medical University, Shenyang, China
Objective: To obtain insight into the role of
cytokines in SIRS/MODS and the relationships with the severity of SIRS/MODS
through kineticly observing the variety of TNF-a, IL-1b, IL-6 in SIRS children, and to
initiately probe into the pathogenesis of SIRS and MODS, and to provide
theoretical basis for clinical prevention and therapy.
Methods: 86 patients admitted in PICU were
studied. They were divided into SIRS group (n=67) and non-SIRS group (n=19)
according to the diagnosis standard of children SIRS.SIRS group was divided
into S1 group (n=37), S2 group (n=18) and S3
group (n=12) according to its conforming to SIRS diagnosis standard 2
items, 3 items and 4 items respectively. MODS group was divided into M2-M7
group according to the numbers of involved organs. Blood samples were
collected on day 1,3 and 5 in hospital. Samples were assayed for TNF-a, IL-1β, IL-6
using IMMULITE chemiluminescent immunometric analyzer. Data were expressed
as means±SEM. The SPSS10.0 software was used to evaluate the data.
Results: (1) TNF-a levels of SIRS group were
significantly higher than that of non-SIRS group and control group on day
1,3 and 5（p<0.05）. TNF-a levels increased significantly in proper order in
S1 , S2 and S3 group. There was
statistical significance between S3 group and S1 , S2
group（p<0.05）. TNF-a of MODS group and death group were significantly
higher than that of non-MODS group and non-death group on day 1,3 and 5（p<0.05）. TNF-a levels of M2-M7 group
increased significantly in proper order. The level of TNF-a appeared to be correlated with morbidity of MODS
and death.
(2)
IL-1β levels of SIRS group were significantly
higher than that of non-SIRS group and control group on day 1,3 and 5（p<0.05）. IL-1βlevels increased gradually in S1 ,S2
and S3 group. But there was no statistical significance
amongthem（p>0.05）. IL-1βof MODS group were significantly higher than that
of non-MODS group on day 1,3 and 5 （p<0.05）.IL-1βlevels
of M2-M7 group increased in proper order, but
difference was not significant（p>0.05）. Although IL-1βof
death group was higher than that of non-death group on day 1,3 and 5, there
was no statistical significance（p>0.05）. The level of IL-1βwas
associated with MODS, but not correlated with death.
(3)
IL-6 levels of SIRS group were significantly higher than that of non-SIRS
group and control group on day 1,3 and 5（p<0.05）. IL-6 levels of S1 , S2 and
S3 group increased significantly in proper order（p<0.05）. IL-6
of MODS group and death group was significantly higher than that of
non-MODS group and non-death group. IL-6 levels of M2-M7
group increased accordingly. The level of IL-6 appeared to be correlated
with MODS and death（p<0.05）.
Conclusion: TNF-a, IL-1βand
IL-6 play a key role in the development of SIRS/MODS. They can reflect the
severity, and increasing TNF-α,IL-1βand IL-6 continuelly may point out bad prognosis.
They can be the assistant index of SIRS /MODS, understanding the roles of
and interrelationships between these cytokines and SIRS/MODS may lead to
innovative therapeutic and preventive measures.