不同手术方式对门静脉高压症患者血浆中ICAM-1水平影响的临床研究

THE EFFECT OF DIFFERENT METHODS OF OPERATION ON PLASMA ICAM-1 LEVELS IN PATIENTS WITH PORTAL HYPERTENTION

目的研究不同手术方式对门静脉高压症患者手术后血浆中细胞粘附因子-1(ICAM-1以下同)水平的动态变化规律及其意义。方法采用随机、双盲法收集外伤性脾破裂和门静脉高压症患者手术前和手术后3、7、14天、6月血浆标本,采用双抗体夹心酶联免疫吸附法(EL ISA)测定血浆中ICAM-1及检测同期肝功能。结果所有患者手术后血浆中ICAM-1水平升高,至术后14天达到高峰,门静脉高压症组手术后,早期增高更明显(P<0.05);14天后下降,与同时期肝功能变化呈正相关;6月后联合手术组患者血浆中ICAM-1明显低于其它手术组。结论门静脉高压症患者手术后早期血浆中ICAM-1水平升高,是门静脉血栓形成的高峰时间。

Objective To study the effect of different methods of operation on postoperative plasma intercellular adhesion molecule （ICAM-1）leves in patients With portal hypertention and its significance. Methods The plasma samples of a total of 75 cases of patients of traumatic rupture of spleen or portal hypertention were collected before operation and on the 3rd,Tth,14th dayand 6th month after operation. The plasma ICAM-1 levels were detected by standard enzymatic methods. Result The postoperative plasma ICAM-1 levels increased in all patients and reached to peak levels in the 14th day after operation and compared with control group,it was higher in the portal hypertention group（P〈0.05）. Then the plasma ICAM-1 levela decreased and six months later,compared with other operation groups,it was lower in the combination operation group（P〈0. 05）. Conclusion The plasma ICAM-1 levels incrased in the patients of portal hypertenion in the early stage after operation and this stage is the fastigium of the formation of vein thrombus.