여성 단순급성신우신염 환자에서 혈중 및 요중 싸이토카인의 임상적 유용성
The Clinical Significance of Serum and Urine Cytokines in Patients with Acute Uncomplicated Pyelonephritis
신태섭, 명순철, 장인호, 김태형, 김경도,
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신태섭 ( Shin Tae-Seoup )
한림대학교 의과대학 비뇨기과학교실
명순철 ( Myung Soon-Chul )
중앙대학교 의과대학 비뇨기과학교실
장인호 ( Chang In-Ho )
중앙대학교 의과대학 비뇨기과학교실
김태형 ( Kim Tae-Hyoung )
중앙대학교 의과대학 비뇨기과학교실
김경도 ( Kim Kyung-Do )
중앙대학교 의과대학 비뇨기과학교실
KMID : 0358320090500010033
Abstract
Purpose: In this prospective study, we evaluated the clinical significance of inflammatory cytokines in women with acute uncomplicated pyelonephritis undergoing antimicrobial therapy.
Materials and Methods: We analyzed 26 female patients diagnosed with acute uncomplicated pyelonephritis between September 2007 and March 2008. Body temperature, white blood cell(WBC) counts, serum C-reactive protein(CRP), and serum and urine interleukin(IL)-6 and IL-8 were measured before and 12 hours, 24 hours, and 4 days after the intravenous administration of empirical ciprofloxacin.
Results: Initial serum CRP levels were correlated with initial serum IL-6 and initial urine IL-8 levels. Twenty-four hours after the start of antibiotic treatment, the CRP level and urine IL-8 level continued to be high, whereas serum IL-6 levels decreased significantly(26.1±32.4 vs 9.9±23.5pg/dl, p＜0.01). When we divided the patients into mild(CRP＜15mg/dl, n=14) and severe (CRP≥15mg/dl, n=12) groups according to initial CRP levels, the serum IL-6 level decreased significantly in both the mild(14.2±4.0 vs 4.0±1.7pg/dl, p＜0.01) and the severe(41.1±12.7 vs. 22.7±16.4pg/dl, p＜0.01) groups within 24 hours, whereas CRP and urine IL-8 levels did not change significantly in either group.
Conclusions: Clinically, initial serum IL-6 and urine IL-8 levels were increased according to disease severity. Moreover, the serum IL-6 level decreased rapidly after antibiotic treatment within 24 hours. Serum IL-6 levels are a better indicator of the severity of disease and the therapeutic effect of empirical parenteral antibiotic use in patients with acute uncomplicated pyelonephritis than were either CRP or WBC counts.(Korean J Urol 2009;50:33-38)
키워드
Cytokines;Interleukin-6;Pyelonephritis
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