Thay đổi Cytokin trong máu ngoại vi ở trẻ viêm phổi thở máy

on of pulmonary immunity. Adv Immunol, 59,
369 - 455.

độ IL - 6 trong máu cao là yếu tố tiên lượng tử

3. Burns AR, Smith CW, Walker DC

vong ở trẻ [4]. Kết quả nghiên cứu này cho

(2003). Unique structural features that influen-

thấy nồng độ IL - 6 trong máu cao ở nhóm

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viêm phổi tử vong so với nhóm viêm phổi

Rev, 83, 309 – 336.

sống (267,12 pg/ml so với 20,75 pg/ml,
p = 0,05). Điều này chứng tỏ nồng độ IL - 6

4. Montón C., Torres A (1998). Lung
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cao trong máu là yếu tố tiên lượng bệnh nặng

Arch Chest Dis, 53(1), 56 - 63.

có thể tử vong.

V. KẾT LUẬN
Các cytokin như IL - 6, IL - 8, IL - 10, GM -

5. Ann Craig (2009). Neutrophil Recruitment to the lungs during Bacterial Pneumonia.
Infection and Immunity, 77(3), 568 - 575.

CSF có vai trò quan trọng trong phát động quá

6. Endeman H (2011). Systemic cytokine
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trình viêm ở bệnh nhân viêm phổi nặng. Nồng

pneumonia. Eur Respir J, 37(6), 1431 - 1438.

độ IL - 6 cao tiên lượng bệnh nặng, nguy cơ
tử vong cao.

Lời cám ơn
Chúng tôi xin chân thành cám ơn các bác
sỹ, điều dưỡng tại khoa Hồi sức cấp cứu,
bệnh viện Nhi Trung ương đã giúp chúng tôi
thực hiện đề tài này. Chúng tôi cũng xin cám
ơn các kỹ thuật viên khoa Hóa sinh, bệnh
viện Nhi Trung ương, các cán bộ tại Labo
Miễn dịch, Viện Quân y 103 đã giúp chúng tôi
lưu trữ mẫu xét nghiệm, định lượng cytokine
trong máu.

TÀI LIỆU THAM KHẢO

1. Anderson M.R (1997). Advances in the

TCNCYH 98 (6) - 2015

7. Wick YJ (2012). Proinflammatory Cytokines: A Guide to Antibiotic Therapy for Pneumococcal Pneumonia. Published Online: www.
pharmacytimes.com.
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The Role of Cytokines in Mediating Lung Inflammation. Medscape Pulmonary Medicine
eJournal

3(2).

Available

at:

http://

www.medscape.com/viewarticle/408743.

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TẠP CHÍ NGHIÊN CỨU Y HỌC

Summary
THE CHANGE OF CYTOKINES IN PERIPHERAL BLOOD IN CHILDREN
WITH SEVERE PNEUMONIA REQUIRED MECHANICAL VENTILATION
Pneumonia is a common respiratory disease in children. The inflammatory responses influence the progression of the disease. The most important inflammatory reaction is to release a
variety of cytokines by inflammatory cells. The cytokines play an important role for amplification
of lung inflammation. The aim of this study is to find the change of cytokines in peripheral blood in
children with severe pneumonia requiring mechanical ventilation. This is a prospective descriptive
study on children with severe pneumonia requiring mechanical ventilation and healthy children.
Blood tests were performed within the first 24 hours after intubation. Within six months, we
recruited 45 children with severe pneumonia requiring mechanical ventilation and 35 healthy
children to participate in this research. The levels of proinflammatory cytokines such as IL - 6,
IL - 8, GM - CSF were increased significantly in the study group when compared with the control
group. IL - 6 levels were increased by 3924% (80.84 pg/ml versus 2.06 pg/ml; p = 0.01), IL - 8
levels were increased 1360% (90.03 pg/ml versus 6.62pg/ml, p < 0.001), GM - CSF levels were
increased 1007% (115.58 pg/ml versus 11.47 pg/ml; p < 0.001). IL - 10 levels in children with
pneumonia under 6 months old were significantly higher in comparison with children more than 6
months old. Children with high levels of IL-6 in the first day of intubation have a higher mortality
risk than children with low levels of IL - 6 (267.12 pg/ml versus 20.75 pg/ml, p = 0.05). In conclusion, the cytokines such as IL - 6, IL - 8, IL - 10, GM - CSF play an important role in inducing the
inflammatoty responses in children with pneumonia. High IL - 6 levels predict the severity and the
risk of death of children with pneumonia.
Key words: Severe pneumonia required mechanical ventilation, cytokines

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