Serum and Peritoneal Lavage Fluid Cytokines Correlate with Acute Abdomen Severity.

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  • 血中，腹水中サイトカイン濃度からみた腹膜炎の病態評価に関する臨床的検討

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Abstract

To evaluate the correlation between serum and paritoneal lavage fluid (PLF) cytokines and the clinical severity of patients diagnosed with acute abdomen. Methods: Subjects numbered 16-13diagnosed with digestive tract perforation and 3 with strangulating bowel obstruction. Of the 13 with perforation, 9 involved the upper digestive and 4 the lower digestive tract. Blood samples and PLF were collected immediately after laparotomy. TNFα, IFN-γ, IL-6, and IL-10 concentration in serum and PLF were measured by enzymelinked immunosorbent assay. Clinical status was analyzed based on systemic inflammatory response syndrome (SIRS) criteria. Results: Five of the 9 with upper digestive and all 4 with lower digestive tract perforation met SIRS criteria. Serum IL-10 in those with lower digestive tract perforation was significantly higher than in those with upper digestive tract perforation. PLF IL-10 in those with SIRS was significantly higher than in those without SIRS. PLF IL-10 in those with SIRS 4 scores was significantly higher than in those with SIRS 2 or 3 scores. PLF IFNγin those with SIRS 4 scores was significantly lower than in those with SIRS 2 or 3 scores. Conclusions: PLF IL-10 and IFNγratios correlate positively with acute abdomen severity based on SIRS criteria.

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