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KMID : 0350519950480030715
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Journal of Catholic Medical College
1995 Volume.48 No. 3 p.715 ~ p.725
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Changes in Plasma Levels of Tumor Necrosis Factor-αand Soluble Intercelluiar Adhesion Molecule-1 in Patients with Adult Respiratory Distress Syndrome
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Abstract
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Although the pathogenesis of Adult Respiratory Distress Syndrome (ARDS) is undoubtedly complex and poorly understood, several observations point to the important roles of polymorphonuclear neutrophils, several cytokines and adhesion molecules.
To assess the potential roles of Tumor Necrosis Factor-α (TNF-α) and soluble Intercellular Adhesion Molecule-1 (Sicam-1) in the pathogenesis and prognosis of ARDS, we measured the plasma levels of TNF-α and Sicam-1 in 10 patients with ARDS and
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healthy normal as a control by Radioimmunoassay and Enzyme-linked immunosorbent assay methods.
According to the cause of APDS, we classified patients into sepsis (n=7) and non-sepsis groups (n=3) and made a comparof plasma levels of TNF-αand sICAM-1 between the two groups. We also compared the plasma levels of TNF-α and sICAM-1 between
the
survivors and the non-survivors to clinical indicies that have been egarded as prognostic factors of ARDS.
@ES The results were as follows :
@EN 1. Mean plasma levels of TNF-α in patients with both septic and non-septic ARDS were significantly higher than the normal control (P<0.05).
2. Mean plasma levels of sICAM-1 in patients with ARDS were higher than the norrnal controls, and significantly higher in the septic ARDS group (P<0.01).
3. However, in patients with ARDS, mean plasma levels of TNF-α and sICAM-1 did not differ significantly between the survivors and the non-survivors (P>0.05).
4. In patients with ARDS, there was a poor correlation between the serial plasma levels of TNF-α and prognosis (r=-0.898, P>0.05). However, in the survivors, serial plasma levels of TNF-α had a tendency to decrease, and in the non-survivors,
it
the
non-survivors, it had a tendency to increase.
5. In patients with ARDS, there was a poor correlation between the serial plasma levels of sICAM-1 and prognosis (r=0.525, P>0.05). However, in the survivors, serial plasma levels serial plasma levels of sICAM-1 had a tendency to decrease, and
in
non-survivors, it had a tendency to increase.
These results indicate that the plasma levels of TNF-αand sICAM-1are higher in patients with ARDS, and even more so in septic ARDS patients. But, this elevation is not associated with the clinical severity and the prognosis of ARDS.
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KEYWORD
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