Niveles
plasmáticos de interleucina-1ß e interleucina-6 en recién nacidos con fiebre
Dres. Rita de C. Silveira 1, Renato S.
Procianoy 2
Palabras clave: Recién
nacido | Fiebre | Interleucina-1ß | Interleucina-6
Correspondencia:
Dr. Renato S. Procianoy. Rua Tobias da Silva, 99/302. CEP 90570-020. Porto
Alegre (RS), Brasil.
Resumen
Objetivo:
evaluar los niveles plasmáticos de IL-1ß e IL-6, con la finalidad de
diferenciar la presencia o no de infección bacteriana en recién nacidos con
fiebre.
Método: Durante el período de julio de 1995 a agosto de 1996, fue
estudiada una cohorte de 117 recién nacidos, entre 0 y 5 días de vida, sin uso
previo de antibioticoterapia y con alguna sospecha clínica de infección
bacteriana.
Los recién nacidos con criterios definidos para sepsis, constituyeron los
recién nacidos infectados. Se definió fiebre como temperatura axilar
37,5ºC. en tres tomas independientes. Los pacientes fueron clasificados
en cuatro grupos: Grupo 1: infectados y con fiebre; Grupo 2: infectados y sin
fiebre; Grupo 3: no infectados y con fiebre; Grupo 4: no infectados y sin
fiebre. Fueron obtenidos hemograma, recuento plaquetario, hemocultivo o
cualquier otro cultivo, y niveles plasmáticos de IL-1ß e IL-6 antes del inicio
de la terapia antimicrobiana.
Resultados: de los 117 recién nacidos estudiados, había 66 con infección
y 51 sin infección. La fiebre estaba presente en 45 (38,46%). Las medianas de
la IL-1ß e IL-6 fueron significativamente superiores en los recién nacidos con
fiebre que en los sin fiebre. Hubo diferencias significativas entre los grupos
1 y 2, 1 y 4, y 2 y 3 para IL-1ß. No hubo diferencia significativa entre los
grupos 2 y 4 y 1 y 3 para IL-1ß. En los recién nacidos sin infección y con
fiebre, la misma ocurrió en ocho (72%) por exceso de calor y en apenas tres por
deshidratación. Los grupos 1 y 2 y los grupos 3 y 4 no presentaron diferencias
significativas en los niveles de IL-6. Hubo diferencias significativas en los
niveles de IL-6 entre los grupos 1 y 3 y los grupos 1 y 4.
Conclusiones: IL-6 es un marcador de sepsis neonatal precoz. IL-1ß está
relacionada con la respuesta febril del recién nacido independientemente de la
presencia de infección bacteriana.
Objective: to study plasma levels of IL-Iß and IL-6 in
order to distinguish the presence of bacterial infection in newborn infants
with fever.
Methods: a cohort of 117 newborns infants with postnatal age equal or less than
5 days, with no previous use of antibiotic therapy, and with clinical suspicion
of bacterial infection was studied from July 1995 through August 1996. Those
with define criteria for sepsis were considered infected. Fever was defined as
axillar temperature equal or greater than 37,5°C in three independent
measurements. The patients were classified in three different groups: Group 1:
infected with fever; Group 2: infected without fever; Group 3:not infected with
fever; Group 4: not infected without fever. Complete blood count, platelet
count, blood or other fluid cultures, and plasmatic levels of IL-1ß and IL-6
were collected before the beginning of antibiotic therapy.
Results: of the 117 newborn infants studied were 66 infected and 51 not
infected. Fever was present in 45 (38,46%). The median values of IL-Iß and IL-6
were significantly higher in newborn infants with fever than in those with no
fever. There were significant differences between groups 1 and 2, 1 and 4, and
2 and 3 for IL-Iß. There were no significant differences between groups 2 and
4, and 1 and 3 for IL-Iß. Eight (72%) newborn infants with no infection and no
fever had environment heating, and three had dehydration. There were no
differences in median IL-6 levels between groups 1 and 2, and 3 and 4. There
were significant differences in the median IL-6 levels between groups 1 and 3,
and 1 and 4.
Conclusions: IL-6 is a marker of nearly neonatal sepsis, IL-Iß is related to
neonatal fever response independently of the presence of bacterial infection.
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