入院时血清中的 il-6 和 il-10 水平与老年髋部骨折患者的并发症有关。

IF 2.2 3区医学 Q3 CRITICAL CARE MEDICINE

Injury-International Journal of the Care of the Injured Pub Date : 2024-10-01 DOI:10.1016/j.injury.2024.111736

Felícito García-Alvarez , Álvaro Chueca-Marco , Luis Martínez-Lostao , María Aso-Gonzalvo , Ruben Estella-Nonay , Jorge Albareda

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引用次数: 0

摘要

目的衰老可能会导致渐进性炎症环境，并改变不同免疫细胞群的功能。本研究旨在探讨某些血清免疫学参数对髋部骨折患者住院时间和并发症的影响。患者和方法对 87 名股骨转子间骨折或 Garden IV 型移位性颅骨下骨折患者（63 名女性）进行了前瞻性研究。平均年龄为 84.43±9 岁，从 65 岁到 104 岁不等。入院时记录了不同合并症的相关数据。患者入院第二天早上采集外周血样本，并测定一系列免疫学参数：白细胞公式、血小板计数、C反应蛋白（CRP）、红细胞沉降率（ESR）、IL-6和IL-10水平、T淋巴细胞计数、细胞数/mm3以及CD3、CD4、CD8、CD3-/CD16/56+（NK细胞）和CD3-/CD19+（B细胞）的百分比。结果 IL-6 血清水平与较高的 CRP（p < 0.001）、IL-10（p = 0.002）和较高的 NK CD56+ 细胞百分比（p = 0.046）呈显著正相关。住院时的 IL-6 血清水平与住院时间延长呈显著正相关（p = 0.037）。IL-6 平均值（40.43 pg/mL）每高出 1 pg/mL，住院时间就增加 0.231 天。入院时血清 IL-10 水平较低与住院期间出现无症状尿路感染有关（p = 0.032）。结论入院时 IL-6 血清水平与髋部骨折老年患者住院时间的延长呈显著正相关。入院时外周血中 IL-10 水平较低与无症状尿路感染有关。CD19+ 细胞数量/mm³越高与肺炎和无症状尿路感染明显相关。入院时的这些免疫变量可作为住院期间并发症的风险指标。

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Serum levels of IL-6 and IL-10 on admission correlate with complications in elderly patients with hip fracture

Objectives

Ageing may cause a progressive pro-inflammatory environment and alter functionality of different immune-cell populations. The aim of the present study is to examine the influence of certain serum immunological parameters on hospitalization stay and complications in patients who have suffered a hip fracture.

Patients and methods

A prospective study was carried out with 87 patients (63 women) presenting with either trochanteric femoral fracture or Garden IV displaced subcapital fracture. The average age was 84.43 ± 9, ranging from 65 to 104 years old. Data regarding different comorbidities were recorded at the time of arrival. The morning after patient's admission peripheral blood samples were obtained and a series of immunological parameters were determined: leukocyte formula, platelets count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), IL-6 and IL-10 levels, T-lymphocytes count, number of cells/mm3 and percentages of CD3, CD4, CD8, CD3-/CD16/56+ (NK cells), and CD³-/CD19+ (B cells).

Results

IL-6 serum levels presented a positive and significant correlation with higher levels of CRP (p < 0.001), IL-10 (p = 0.002), and higher percentages of NK CD56+ cells (p = 0.046). IL-6 serum levels at hospitalization presented a positive and significant correlation with a longer hospitalization stay (p = 0.037). Hospitalization increased by 0.231 days for every 1 pg/mL above the IL-6 mean value (40.43 pg/mL). Lower serum IL-10 levels on admission were associated with the appearance of symptomatic urinary tract infection during hospitalization (p = 0.032). Higher number of CD19+ cells/mm³ presented a significant relationship with pneumonia (p = 0.018) and symptomatic urinary tract infection (p = 0.0019).

Conclusions

IL-6 serum levels on admission showed a positive and significant correlation with a longer hospitalization stay in elderly patients presenting with hip fracture. Lower levels of IL-10 in peripheral blood on admission were associated with symptomatic urinary tract infections. A higher number of CD19+ cells/mm³ was significantly associated with pneumonia and symptomatic urinary tract infection. These immunological variables on admission may serve as risk indicators of complications during hospitalization.

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来源期刊

Injury-International Journal of the Care of the Injured 医学-急救医学

CiteScore

4.00

自引率

8.00%

发文量

699

审稿时长

96 days

期刊介绍： Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.