Objective To study the dynamic change of serum levels of inflammatory and anti-inflammatory cytokines in patients with multiple organ dysfunction syndrome ( MODS) and its predicting value for prognosis. Methods All patients diagnosed as systematic inflammatory response syndrome (SIRS) were divided into MODS group (n = 48) and non-MODS group (n = 30) by their severity, and survival group (n = 37) and deceased group (n =41) by their prognosis. Serum levels of inflammatory, anti-inflammatory cytokines were measured by enzyme-linked immunosorbent assay (ELISA) and intensity of the HLA-DR expression in monocytes was measured by flow cytometry. Results Serum level of inflammatory cytokines in patients of MODS group and deceased group was significantly higher than that in those of non-MODS and survival groups ( P