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Endotoxin, TNFa und IL-6 bei abdomineller Sepsis

Endotoxin, TNFa and IL-6 in abdominal sepsis

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Zusammenfassung

Im Verlauf einer gramnegativen abdominellen Sepsis wurden prospektiv bei 18 Patienten Endotoxin, TNFa und IL-6 im Plasma gemessen und mit dem Überleben sowie der Lungen- und Leberfunktion korreliert. Während Endotoxin (median 12 vs. 9 EU/ml) und TNFa (12 vs. 21 pg/ml) bei Überlebenden und Toten nicht unterschiedlich waren, fand sich eine signifikante Erhöhung von IL-6 bei letalem Verlauf (82 vs. 171 pg/ml, p=0,02). An Tagen mit Lungenversagen war IL-6 signifikant erhöht (70 vs. 159 pg/ml, p=0,009). Endotoxin (11 vs. 13 EU/ml) und TNFa (12 vs. 15 pg/ml) waren bei Patienten mit und ohne respiratorischer Insuffizienz nicht different. Ebenso war IL-6 bei Leberversagen signifikant höher (349 vs. 69 pg/ml, p=0,0000), während für Endotoxin (11 vs. 13 EU/ml) und TNFa (33 vs. 17 pg/ml) kein Unterschied nachgewiesen werden konnte. Bei gramnegativer abdomineller Sepsis fand sich eine Korrelation von IL-6 mit Überleben, Lungen- und Leberfunktion, während Endotoxin und TNFa in diesen Parametern nicht signifikant waren.

Summary

Endotoxin, TNFa and IL-6 were followed prospectively in the course of 18 patients with gramnegative abdominal sepsis and evaluated for a possible correlation with survival, respiratory failure and hepatic dysfunction. Plasma levels of survivors compared with nonsurvivors failed to show a significant correlation for both endotoxin (median 12 vs. 9 EU/ml) and TNFa (median 12 vs. 21 pg/ml). However, IL-6 was elevated markedly in non-survivors (82 vs. 171 pg/ml, p=0.02). On days with respiratory failure IL-6 was significantly higher (70 vs. 159 pg/ml, p=0,009), while endotoxin (11 vs. 13 EU/ml) and TNFa (12 vs. 15 pg/ml) were not different in patients with and without respiratory insufficiency. The same, IL-6 was markedly elevated on days with hepatic dysfunction (349 vs. 69 pg/ml, p=0.0000), while endotoxin (11 vs. 13 EU/ml) and TNFa (33 vs. 17 pg/ml) did not differ significantly. In gramnegative abdominal sepsis IL-6 was found to be of significance with respect to survival, pulmonary and hepatic function, while endotoxin and TNFa failed to differentiate in these terms.

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Authors and Affiliations

  1. I. Chirurgische Universitätsklinik, Alserstraße 4, A-1090, Wien

    R. Függer, M. Rogy, S. Klimann, M. Prager, E. Kyral, G. Hamilton & F. Schulz

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  1. R. Függer
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  2. M. Rogy
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  3. S. Klimann
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  4. M. Prager
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  5. E. Kyral
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  6. G. Hamilton
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  7. F. Schulz
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Prof. Dr. Arnulf Fritsch zum 65. Geburtstag gewidmet.

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Függer, R., Rogy, M., Klimann, S. et al. Endotoxin, TNFa und IL-6 bei abdomineller Sepsis. Acta Chir Austriaca 24, 174–179 (1992). https://doi.org/10.1007/BF02601927

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