断流分流联合手术前后血浆IL-6,IL-8和TNF-α水平的变化及其意义

Alternation of plasma IL-6,IL-8 and TNF-α after pericardial devascularization associated with proximal spleno-renal shunt in cirrhotic patients

目的 探讨门静脉高压症行贲门周围血管离断并脾 -肾静脉分流联合手术前后血浆白细胞介素 -6(IL 6) ,白细胞介素 -8(IL 8)和肿瘤坏死因子 -α(TNF α)水平变化的意义。方法 检测联合手术组患者术前 1d和术后 7d血浆IL 6,IL 8和TNF α含量 ,并与对照组比较。结果 联合手术组术前IL 6,IL 8和TNF α水平分别为 ( 2 3 0 .4± 10 .3 )ng/L ,( 2 0 1.5± 7.8)ng/L及 ( 2 61.5± 2 8.3 )ng/L ,明显高于对照组 (P <0 .0 1) ;联合手术后 7d ,IL 6,IL 8和TNF α水平分别为 ( 13 5 .8± 11.4)ng/L ,( 10 8.2± 8.7)ng/L及 ( 2 11.8± 3 6.5 )ng/L ,与术前比均有明显降低 ,但仍高于对照组 ( P <0 .0 1)。结论 IL 6,IL 8和TNF α的活性在肝硬化门静脉高压症的形成过程中起着重要作用 ;联合手术降低门静脉压力 ,血浆IL 6,IL 8和TNF α水平显著下降 。

Objective To explore the changes of IL-6, IL-8 and TNF-α levels before and after pericardial(devascularization) associated with proximal spleno-renal shunt(combined operation) in cirrhotic patients with portal hypertension. Methods Plasma levels of IL-6, IL-8 and TNF-α in combined(operation ) patients at 1d before(operation),and 7d after operation were measured and compared with control group. Results Preoperatively, the(plasma) levels of IL-6[ (230.4±10.3) ng/L], IL-8 [ (201.5±7.8) ng/L]and TNF-α[ (261.5±28.3) ng/L]in(combined) operation patients were significantly higher than those in control group (P<0.01). At 7d after(operation), the(plasma) levels of IL-6 (135.8±11.4) ng/L-1, IL-8 (108.2±8.7) ng/L-1 and TNF-α (211.8±36.5) ng/L-1 were significantly lower than those at preoperation,but still significantly higher than those in control (P<0.01).Conclusions Serum IL-6, IL-8 and TNF-α play important roles in cirrhotic patients with portal(hypertension).(Combined) operation could significantly decrease portal pressure and plasma level of IL-6, IL-8 and TNF-α, which could be of benefit to the restoration of hepatic function.