Objectives: The purpose of this trial was to investigate in patients with sepsis, the correlation between prognosis of disease and factors, which influence prognosis like gender, focus of infection, bacterial growth in blood culture, growing pathogens in addition to serum levels of cytokines (TNF-α, IL-10, leptin) and C-reactive protein.
Material and methods:Forty-six adult patients with sepsis and 55 healthy adults as control group were enrolled in this study. Serum cytokine (TNF-α, IL-10 and leptin) levels were determined by ELISA method and C-reactive protein (CRP) levels were measured by nephelometric method. Serum cytokine and CRP levels on day 0 (initial), day 3 and day 5 were compared in surviving sepsis patients and patients who died because of sepsis.Results: Serum IL-10 level on day 0 (initial) of adult patients who died as a result of sepsis was found to be higher than surviving patients and the difference was statistically significant (p=0.025). On 3 rd day of treatment, serum TNF-α and CRP levels of patients who dies because of sepsis were higher than values of surviving patients (for TNF-α p=0.033, for CRP p=0.026). In adult patient group with sepsis who died on the 5 th day of treatment, serum TNF-α level was significantly higher than levels in surviving patients (p=0.030).
Conclusion:It was determined that in patients who died due to sepsis, initial serum IL-10 level, TNF-α and CRP levels on 3 rd day of treatment and finally on 5 th day of treatment, only serum TNF-α level was higher than surviving patients. We believe that determining serum TNF-α and IL-10 levels in patients with sepsis before and during treatment will help clinicians to clarify prognosis and enable them to implement appropriate treatment modifications.
Gereç ve yöntem:Çalışmaya 46 erişkin sepsisli hasta ile kontrol grubu olarak ise 55 sağlıklı erişkin dahil edildi. Serum sitokin (TNF-α, IL-10 ve leptin) düzeyleri ELISA yöntemiyle, C-reaktif protein (CRP) düzeyleri ise nefelometrik yöntemle saptandı.Serum sitokin ve CRP düzeyi sepsili ölen hasta grubu ile yaşayanlar arasında başlangıç (0.gün), 3. ve 5.günlerde istatistiksel olarak karşılaştırıldı.Bulgular: Sepsisten ölen erişkin hastalarda başlangıç (0. gün) serum IL-10 düzeyi, yaşayan hastalarinkinden istatistiksel olarak daha yüksek saptandı (p=0.025). Sepsisten ölen hastalarda, tedavinin 3. gününde serum TNF-α ve CRP düzeyleri yaşayan hastalardan daha yüksekti (TNF-α için p değeri=0.033, CRP için p=0.026). Sepsili erişkin hasta grubunda tedavinin 5. gününde ölen hastalarda serum TNF-α düzeyi yaşayan hastalardan daha yüksekti (p=0.03) Sonuç: Sepsisli erişkin hastalrda tedavi başlangıcında serum IL-10 düzeyinin, tedavinin 3. gününde TNF-α ve CRP dü-zeyinin, tedavininin 5. gününde ise sadece serum TNF-α düzeyinin prognostik olduğu belirlendi. Sepsisli hastalarda serum TNF-α ve IL-10 düzeylerinin tedavinin başlangıcında ve tedavi esnasında saptanması hastaların prognozunun belirlenmesinde ve uygun tedavi değişikliklerinin yapılmasında klinisyene yol gösterici olabilir.An...