不同胶体溶液输注对急性胆囊炎手术患者免疫功能的影响

Effect of infusion with different colloidal fluids on immune function in patients undergoing cholecystectomy

目的 观察6％羟乙基淀粉、聚明胶肽液输注对手术患者免疫功能的影响。方法 28例急性胆囊炎手术切除患者分为两组,分别于术前静注6％羟乙基淀粉和聚明胶肽。用夹心法ELISA检测患者术前术后血浆中白介素-10(IL-10)、白介素-6(IL-6)、白介素-8(IL-8)、可溶性白介素-2受体(sIL-2R)、肿瘤坏死因子-α(TNF-α)的浓度。结果 6％羟乙基淀粉、聚明胶肽可降低TNF-α的浓度,聚明胶肽还可以提高抑炎性因子sIL-2R的浓度,而6％羟乙基淀粉还可降低炎性趋化因子IL-8的浓度。结论 术前输注6％羟乙基淀粉、聚明胶肽能预防或减轻手术和麻醉导致的免疫功能失调。

Objective To evaluate the effect of intravenous infusion with gelatine or 6% hydroxyethyl starch on immune function in the patients undergoing cholecystectomy. Methods Twenty-eight patients with acute cholecystitis were randomized into two groups (14 in each group). Group A was administrated with 500 ml of gelatine before anesthesia and group B was administrated with 500 ml of 6% hydroxyethyl starch. Blood samples were collected before infusion and at the end of surgery. Serum concentrations of IL-6, IL-8, IL-10, TNF-α and soluble interleukin-2 (sIL-2) receptors were detected by using enzyme-linked immunosorbent assay (ELISA). Results Serum concentration of TNF-α was reduced in group A and group B. IL-8 levd was reduced in group B. sIL-2 level was increased in group A. Conclusion Infusion with gelation and 6% hydroxyethyl starch before anesthesia could prevent or reduce the disordered immune function caused by anesthesia and surgery.