Expression patterns of plasma von Willebrand factor and serum interleukin—8 in patients with early—stage severe pulmonary contusion.docVIP

Expression patterns of plasma von Willebrand factor and serum interleukin—8 in patients with early—stage severe pulmonary contusion BACKGROUND： von Willebrand factor （vWF） is only released from endothelial cells and platelets and is an in vivo and in vitro marker of endothelial injury in septic patients with acute lung injury （ALI）. Interleukin-8 （IL-8）， as a proinflammatory mediator causing recruitment of inflammatory cells， induces an increase in oxidant stress mediators and makes it as a key parameter for localized inflammation. However， it has not been well established whether the level of serum IL-8 is associated with the severity of lung injury and whether it is a prognosis marker for severe lung contusion. This study was to investigate the expression of plasma vWF and IL-8 and their association with the severity and outcomes of severe pulmonary contusion. METHODS： A total of 63 patients were divided into a severe pulmonary contusion with acute respiratory distress syndrome （ARDS） group and a non-ARDS group， or a survivor group and a non-survivor group， or an injury severity score （ISS） 35. The reason may be that the selection of patients from our study was different from theirs and we divided patients according to ISS≥20 and ISS20. Our study revealed a negative correlation between vWF expression and oxygen index， indicating that vWF could predict the damage of lung function and the severity of lung injury. 　　Mechanical injury can induce serial inflammatory reactions， which may directly or indirectly cause pulmonary injury. Pulmonary contusion activates localized and systemic innate immune mechanisms and recruits neutrophils to the injured lung. Neutrophils are involved in the pathogenesis of ALI/ARDS.[17] Chemokines like IL-8 recruit leukocytes to the injured areas. IL-8 has been identified as the main chemotactic factor for neutrophils in lung fluids of patients with ALI/ARDS.[18] A study [19] reported that IL-8 level increased in the serum and bronchoa