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심폐소생술 후 순환회복 되어 저체온 요법을 시행한 환자에서 신경학적 예후에 따른 혈청 Interleukin-6와 Interleukin-10의 발현 양상
정건영,이미진,양혁준,임용수,김진주,김재광,김정권,이형석 대한응급의학회 2009 大韓應急醫學會誌 Vol.20 No.1
Purpose: We wanted to investigate the serial changes of the serum interleukin-6 (IL-6) and interleukin-10 (IL-10) concentrations, according to the neurological outcome, in patients who received therapeutic hypothermia after successful cardiopulmonary resuscitation. We also wanted to evaluate the usefulness of serum IL-6 and IL-10 as biochemical markers to predict the neurological outcome. Methods: We prospectively evaluated 23 patients who received therapeutic hypothermia after successful cardiopulmonary resuscitation. Blood samples were taken at 0, 4, 12, 24 and 48 hours after the return of spontaneous circulation. We compared the IL-6 and IL-10 levels between the good (CPC 1 to 2) and poor (CPC 3 to 5) neurological outcome (NO) groups. Results: The serum IL-6 level at 0 hr was significantly higher in the good NO group than that in the poor NO group. The periods of time that showed the greatest pattern of change between the good and poor NO groups were 4-12 hr for the IL-6 level and 0-4 hr for the IL-10 level. On the analysis of the ROC curve, the cut-off value for delta IL-10 (0-4 hr) was -5.4 pg/ml (AUC=0.827, sensitivity 80.0%, specificity 93.3%, p=0.032) and the cut-off value for delta IL-6 (4-12 hr) was 62.8 ng/ml (AUC=0.527, sensitivity 80.0%, specificity 34.0%, p=0.861, respectively). Conclusion: Our study suggests that the early delta IL-10 can be used as a neurological prognostic marker for patients who are undergoing therapeutic hypothermia after successful cardiopulmonary resuscitation.