白细胞介素-6在儿童重症创伤早期监测中的意义及临床应用进展
Significance and Research Progress of Interleukin-6 in Early Monitoring of Severe Pediatric Trauma
摘要: 儿童群体创伤暴露风险显著高于成人,重症创伤患儿病情进展迅速且复杂,是导致儿童死亡和长期残疾的主要原因之一。在重症创伤患儿的管理中,早期准确评估对改善预后至关重要。白细胞介素-6 (interleukin-6, IL-6)是一种典型多功能细胞因子,可用于儿童重症创伤严重程度早期评估、脓毒症/MODS风险预警、脓毒症辅助诊断及预后判断,但不能单独作为确诊依据。监测IL-6水平有助于评估儿童重症创伤严重程度,其通路抑制剂具有潜在治疗价值。
Abstract: Children have a significantly higher risk of trauma exposure than adults. Children with severe trauma present rapid and complex disease progression, which constitutes one of the leading causes of pediatric death and long-term disability. Early and accurate assessment is essential for optimizing the prognosis in the clinical management of children with severe trauma. Interleukin-6 (IL-6) is a typical multifunctional cytokine. It can be used for the early assessment of injury severity, early warning of sepsis and multiple organ dysfunction syndrome (MODS), auxiliary diagnosis of sepsis, and prognostic evaluation in children with severe trauma, whereas it cannot be used alone as the definitive diagnostic criterion. Monitoring IL-6 levels contributes to evaluating the severity of severe pediatric trauma, and inhibitors targeting its signaling pathway possess potential therapeutic value.
文章引用:徐杰, 杨箬雨, 任帅. 白细胞介素-6在儿童重症创伤早期监测中的意义及临床应用进展[J]. 临床个性化医学, 2026, 5(3): 45-50. https://doi.org/10.12677/jcpm.2026.53182

参考文献

[1] Cintean, R., Eickhoff, A., Zieger, J., Gebhard, F. and Schütze, K. (2022) Epidemiology, Patterns, and Mechanisms of Pediatric Trauma: A Review of 12,508 Patients. European Journal of Trauma and Emergency Surgery, 49, 451-459. [Google Scholar] [CrossRef] [PubMed]
[2] Kyu, H.H., Pinho, C., Wagner, J.A., Brown, J.C., Bertozzi-Villa, A., Charlson, F.J., et al. (2016) Global and National Burden of Diseases and Injuries among Children and Adolescents between 1990 and 2013: Findings from the Global Burden of Disease 2013 Study. JAMA Pediatrics, 170, 267-287. [Google Scholar] [CrossRef] [PubMed]
[3] Shimony, N., Dailey, T., Barrow, D., Bui, A., Noureldine, M.H.A., Martínez-Sosa, M., et al. (2021) Pediatric Mild Head Trauma: Is Outpatient Follow-Up Imaging Necessary or Beneficial? Journal of Neurosurgery: Pediatrics, 28, 62-68. [Google Scholar] [CrossRef] [PubMed]
[4] Li, R., Ye, J.J., Gan, L., Zhang, M., Sun, D., Li, Y., et al. (2023) Traumatic Inflammatory Response: Pathophysiological Role and Clinical Value of Cytokines. European Journal of Trauma and Emergency Surgery, 50, 1313-1330. [Google Scholar] [CrossRef] [PubMed]
[5] Leal-Santos, B.F., Lima, H.R., Marques, P.A., et al. In-Hospital Mortality Due to Infectious Disease in an Internal Medicine Department. Epidemiology and Risk Factors. European Review for Medical and Pharmacological Sciences, 19, 567-572.
[6] Behrens, E.M. (2024) Cytokines in Cytokine Storm Syndrome. In: Cron, R.Q. and Behrens, E.M., Eds., Cytokine Storm Syndrome, Springer, 173-183. [Google Scholar] [CrossRef] [PubMed]
[7] Murakami, M., Kamimura, D. and Hirano, T. (2019) Pleiotropy and Specificity: Insights from the Interleukin 6 Family of Cytokines. Immunity, 50, 812-831. [Google Scholar] [CrossRef] [PubMed]
[8] Hunter, C.A. and Jones, S.A. (2015) IL-6 as a Keystone Cytokine in Health and Disease. Nature Immunology, 16, 448-457. [Google Scholar] [CrossRef] [PubMed]
[9] Barrett, D. (2024) IL-6 Blockade in Cytokine Storm Syndromes. In: Cron, R.Q. and Behrens, E.M., Eds., Cytokine Storm Syndrome, Springer, 565-572. [Google Scholar] [CrossRef] [PubMed]
[10] Tanaka, T., Narazaki, M. and Kishimoto, T. (2018) Interleukin (IL-6) Immunotherapy. Cold Spring Harbor Perspectives in Biology, 10, a028456. [Google Scholar] [CrossRef] [PubMed]
[11] Giraldez, M.D., Carneros, D., Garbers, C., Rose-John, S. and Bustos, M. (2021) New Insights into IL-6 Family Cytokines in Metabolism, Hepatology and Gastroenterology. Nature Reviews Gastroenterology & Hepatology, 18, 787-803. [Google Scholar] [CrossRef] [PubMed]
[12] Kang, S. and Kishimoto, T. (2021) Interplay between Interleukin-6 Signaling and the Vascular Endothelium in Cytokine Storms. Experimental & Molecular Medicine, 53, 1116-1123. [Google Scholar] [CrossRef] [PubMed]
[13] García-Juárez, M. and Camacho-Morales, A. (2022) Defining the Role of Anti-and Pro-Inflammatory Outcomes of Interleukin-6 in Mental Health. Neuroscience, 492, 32-46. [Google Scholar] [CrossRef] [PubMed]
[14] Schett, G. (2018) Physiological Effects of Modulating the Interleukin-6 Axis. Rheumatology, 57, ii43-ii50. [Google Scholar] [CrossRef] [PubMed]
[15] Hung, S., Lan, H., Han, S., Wu, C. and Chen, K. (2020) Current Evidence and Limitation of Biomarkers for Detecting Sepsis and Systemic Infection. Biomedicines, 8, Article 494. [Google Scholar] [CrossRef] [PubMed]
[16] Biffl, W.L., Moore, E.E., Moore, F.A. and Peterson, V.M. (1996) Interleukin-6 in the Injured Patient: Marker of Injury or Mediator of Inflammation? Annals of Surgery, 224, 647-664. [Google Scholar] [CrossRef] [PubMed]
[17] Brands, X., Haak, B.W., Klarenbeek, A.M., Otto, N.A., Faber, D.R., Lutter, R., et al. (2020) Concurrent Immune Suppression and Hyperinflammation in Patients with Community-Acquired Pneumonia. Frontiers in Immunology, 11, Article 796. [Google Scholar] [CrossRef] [PubMed]
[18] Choy, E.H., De Benedetti, F., Takeuchi, T., Hashizume, M., John, M.R. and Kishimoto, T. (2020) Translating IL-6 Biology into Effective Treatments. Nature Reviews Rheumatology, 16, 335-345. [Google Scholar] [CrossRef] [PubMed]
[19] Sharma, D., Farahbakhsh, N., Shastri, S. and Sharma, P. (2018) Biomarkers for Diagnosis of Neonatal Sepsis: A Literature Review. The Journal of Maternal-Fetal & Neonatal Medicine, 31, 1646-1659. [Google Scholar] [CrossRef] [PubMed]
[20] Haas, C.B., Lovászi, M., Pacher, P., de Souza, P.O., Pelletier, J., Leite, R.O., et al. (2021) Extracellular Ectonucleotidases Are Differentially Regulated in Murine Tissues and Human Polymorphonuclear Leukocytes during Sepsis and Inflammation. Purinergic Signalling, 17, 713-724. [Google Scholar] [CrossRef] [PubMed]
[21] Erkus, S., Turgut, A. and Kalenderer, O. (2022) Alterations in Serum IL-6 Levels in Traumatized Pediatric Patients: A Preliminary Study for Second Hit Concept. Journal of Orthopaedic Science, 27, 440-447. [Google Scholar] [CrossRef] [PubMed]
[22] Ma, Y., Wang, Y., Yao, Y., Zhang, C., Tang, Q., Zhang, H., et al. (2023) High Serum Interleukin-6 Concentration Upon Admission Is Predictive of Disease Severity in Paediatric Trauma Patients. European Journal of Trauma and Emergency Surgery, 49, 2287-2294. [Google Scholar] [CrossRef] [PubMed]
[23] Qing, H., Desrouleaux, R., Israni-Winger, K., Mineur, Y.S., Fogelman, N., Zhang, C., et al. (2020) Origin and Function of Stress-Induced IL-6 in Murine Models. Cell, 182, 372-387.e14. [Google Scholar] [CrossRef] [PubMed]
[24] Takahashi, W., Nakada, T., Yazaki, M. and Oda, S. (2016) Interleukin-6 Levels Act as a Diagnostic Marker for Infection and a Prognostic Marker in Patients with Organ Dysfunction in Intensive Care Units. Shock, 46, 254-260. [Google Scholar] [CrossRef] [PubMed]
[25] Qiao, Z., Wang, W., Yin, L., Luo, P., Greven, J., Horst, K., et al. (2017) Using IL-6 Concentrations in the First 24 H Following Trauma to Predict Immunological Complications and Mortality in Trauma Patients: A Meta-Analysis. European Journal of Trauma and Emergency Surgery, 44, 679-687. [Google Scholar] [CrossRef] [PubMed]
[26] Dekker, A.E., Krijnen, P. and Schipper, I.B. (2016) Predictive Value of Cytokines for Developing Complications after Polytrauma. World Journal of Critical Care Medicine, 5, 187-200. [Google Scholar] [CrossRef] [PubMed]
[27] Paraschos, M.D., Patrani, M., Pistiki, A., Katsenos, C., Tsaganos, T., Netea, M.G., et al. (2015) Defective Cytokine Production Early after Multiple Traumas: Modulation in Severe Sepsis. Cytokine, 76, 222-226. [Google Scholar] [CrossRef] [PubMed]
[28] Srisangthong, P., Wongsa, A., Kittiworawitkul, P. and Wattanathum, A. (2013) Early IL-6 Response in Sepsis Is Correlated with Mortality and Severity Score. Critical Care, 17, Article No. P34. [Google Scholar] [CrossRef
[29] Uusitalo-Seppälä, R., Koskinen, P., Leino, A., Peuravuori, H., Vahlberg, T. and Rintala, E.M. (2011) Early Detection of Severe Sepsis in the Emergency Room: Diagnostic Value of Plasma C-Reactive Protein, Procalcitonin, and Interleukin-6. Scandinavian Journal of Infectious Diseases, 43, 883-890. [Google Scholar] [CrossRef] [PubMed]
[30] Roth, G., Moser, B., Krenn, C., Brunner, M., Haisjackl, M., Almer, G., et al. (2003) Susceptibility to Programmed Cell Death in T-Lymphocytes from Septic Patients: A Mechanism for Lymphopenia and Th2 Predominance. Biochemical and Biophysical Research Communications, 308, 840-846. [Google Scholar] [CrossRef] [PubMed]
[31] 牛凯旋, 吴淑璐, 刘成, 等. 血清淀粉样蛋白A和白细胞介素-6对脓毒症诊断及病情严重程度评估的临床价值[J]. 中华全科医学, 2022, 20(9): 1484-1487.
[32] Park, S. and Hwang, S. (2018) Prognostic Value of Serum Levels of S100 Calcium-Binding Protein B, Neuron-Specific Enolase, and Interleukin-6 in Pediatric Patients with Traumatic Brain Injury. World Neurosurgery, 118, e534-e542. [Google Scholar] [CrossRef] [PubMed]
[33] Brunner, H.I., Ruperto, N., Zuber, Z., Keane, C., Harari, O., Kenwright, A., et al. (2015) Efficacy and Safety of Tocilizumab in Patients with Polyarticular-Course Juvenile Idiopathic Arthritis: Results from a Phase 3, Randomised, Double-Blind Withdrawal Trial. Annals of the Rheumatic Diseases, 74, 1110-1117. [Google Scholar] [CrossRef] [PubMed]
[34] Barayan, D., Abdullahi, A., Vinaik, R., Knuth, C.M., Auger, C. and Jeschke, M.G. (2021) Interleukin‐6 Blockade, a Potential Adjunct Therapy for Post‐burn Hypermetabolism. The FASEB Journal, 35, e21596. [Google Scholar] [CrossRef] [PubMed]