Study of Interleukin-6 (IL-6) in Patients with Acute Cerebral Injury.
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Patients with severe cerebral injuries exhibit a profound acute phase response. IL-6 is an important mediator of this pathophysiological change, so we monitored IL-6 in serum and cerebrospinal fluid (CSF) of 121 patients with severe cerebral injury to determine the role of IL-6 in such patients. Serum IL-6 concentrations were elevated in all patients on admission but not dramatically higher than in sepsis cases. Medians were meningoencephalitis 23.0, subarachnoid hemorrhage 65.0, cerebral contusion 106.0. cerebral infarction 109.0, subdural hematoma 141.5, other origins of unconciousness 166.5, cerebral hemorrhage 177.0, CPAOA 227.0, and sepsis 6055.0pg/ml. In survivors, serum IL-6 decreased during the subacute period. In nonsurvivors, serum IL-6 increased during the clinical course after brain death. The correlation between serum IL-6 and the IL-10 ratio was significantly associated with the prognosis of these patients. The CSF concentration of IL-6 was significantly higher than the serum of subarachnoid hemorrhage, meningoencephalitis, and other origins of unconciousness. Ratios of CSF/serum were subarachnoid hemorrhage 73.6, meningoencephalitis 26.3, and other origins of unconciousness 8.5. In acute cerebral injury, the process of ischemia, inflammation, and coagulation system activation are interrelated, and may lead to disturbances of the microvascular astrocyte-neuron relationship. The regulation of IL-6 analyzed in these patients was found to be dependent on IL-6 production in the central nervous system. The brain inflammatory response regulation mechanisum differed from that of systematic production.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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