A STUDY ON ROLES OF PHOSPHOLIPASE A₂ AND CYTOKINES ON CRITICAL ILLNESS

Wang XY, Lu ZY, Kuang FW

ICU, Children’s Hospital, Chongqing University of Medical Sciences, Chongqing, China

Objective: To study the roles of phospholipase A₂ (PLA₂) and cytokines (CKs) in children with critical illness.

Methods: The serum concentrations of PLA₂ and CKs were determined in 65 children with critical illness and 20 healthy children by ELISA method. The glucose and lactate levels and arterial blood oxygenic pressure were measured simultaneously along with the organ functions.

Results: PLA₂, TNF-a, IL-6 and IL-8 (mg/L) levels in the acute stages of the illness were (0.68±10.579) mg/L, (0.518±0.336) mg/L, (5.5±2.2) mg/L, (0.508±0.328) mg/L, respectively, which were significantly elevated as compared with those of controls [(0.171±0.019) mg/L, (0.082±0.009) mg/L, (2.3±0.6) mg/L, (0.052±0.019)mg/L]. The mean values of PLA₂, TNF-a, IL-6 and IL-8 in children with critical care scores under 70 [(1.3±0.7) mg/L, (0.8±0.3) mg/L, (7.7±1.8)mg/L, (0.71±0.18) mg/L] and those of the multiple systemic organ failure were significantly higher than those with scores of 71~89 [(0.51±0.14) mg/L, (0.43±0.15) mg/L, (5.5±0.9) mg/L, (0.53±0.10)mg/L]. The mean values of PLA2 and CKs in children with multiple systemic organ failure were significantly higher than those with single organ failure (P<0.05, or P<0.01).The mean serum concentrations of PLA₂ and CKs were remarkedly higher in children with deteriorative diseases than in children with recoverable diseases, and were the highest in deathbed children (P<0.001).The serum PLA₂ levels correlated positively with the CKs, glucose and lactate levels, and negatively with PaO₂ and critical care scores.

Conclusion: PLA₂ and CKs are involved in all pathophysiologic process of the development of critical illness. Combined with critical care scores, PLA₂ and CKs are probably useful clinical values for evaluation of the severity and prognosis of critical illness.

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