Clinical significance of acute gastrointestinal injury grades in inflammatory response of critically ill patients

Abstract

Objective: To explore the value of acute gastrointestinal injury (AGI) grades in inflammatory response of critically ill patients. Methods: Ptients with AGI severity from Ⅰ to Ⅳ were randomly selected(20 for each)from July 2014 to June 2015 in ICU of Yantai Yuhuangding Hospital. The expression of NF-κB were detected by immunofluorescence. The expression of TNF-α and IL-6 were detected by enzyme linked immunosorbent assay (ELISA). Procalcitonin (PCT) and C reactive protein (CRP) were measured. Statistical analysis was carried out. Results: For AGI grade Ⅰ and AGI grade Ⅱ patients, NF- κB p65 were located mainly in cytoplasm. For AGI grade Ⅲ and AGI grade Ⅳ patients, NF-κB p65 were mainly located in the nucleus, indicating that inflammatory stimulation induces nuclear translocation of NF-κB. With the higher grade of AGI, TNF-α and IL-6 secretion increased significantly.For AGI grade Ⅰ to grade Ⅳ patients, TNF-α were expressed as (89.76±19.78)ng/L, (130.54±23.18)ng/L, (224.65±39.02)ng/L, (293.17±36.79)ng/L, and the difference was statistically significant (P<0.05) respectively. IL-6 were expressed as (45.96±9.62)ng/L, (89.26±12.77)ng/L, (203.71±58.26)ng/L, (331.18±64.28) ng/L, the difference was statistically significant (P<0.05). With the higher grade of AGI, PCT and CRP levels were significantly increased.For AGI grade Ⅰ to grade Ⅳ patients, PCT levels were (2.65±1.78) μg/L, (3.92±2.14) μg/L, (9.92±3.89) μg/L, (27.34±8.45) μg/L, and the difference was statistically significant (P<0.05). CRP levels were (13.82±4.93) mg/L, (32.14±8.97) mg/L, (93.49±25.72) mg/L, (183.05±51.36) mg/L, and the difference between each group was statistically significant (P<0.05). Conclusions: There is a certain correlation between AGI classification and inflammatory markers in critically ill patients, which shows that gastrointestinal dysfunction may be the promoter and stimulating factor in systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). This provides a clinical basis for judging the severity of inflammatory response in critically ill patients according to AGI grades.