老年腹部手术患者围手术期细胞因子的变化及临床意义

The change of cytokine and clinical significance in the perioperative period of the treatment of senile patients with abdominal operation

目的:探讨老年患者腹部手术前后肿瘤坏死因子(TNF)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)的变化及其临床意义。方法:随机选取老年腹部手术患者56例,其中伴腹腔感染28例为观察组,另28例为对照组,均采用放射免疫法检测手术前后静脉血TNF、IL-6和IL-8的变化。结果:术前观察组静脉血TNF、IL-6和IL-8水平均显著高于对照组(P<0.01);术后1d两组TNF、IL-6和IL-8水平均显著高于术前(P<0.05);术后7d观察组TNF、IL-6和IL-8水平均较术前显著下降(P<0.01);经相关性分析证明患者静脉血TNF、IL-6与IL-8之间存在正相关关系。结论:腹部感染患者静脉血中TNF、IL-6和IL-8水平明显增高,监测三者的变化可作为观察老年腹部感染患者病情转归的重要指标。

Objective： To study the change of TNF, IL - 6 and IL - 8 and clinical significance of the change before and after the abdominal operation for senile patients. Methods： 56 senile patients with abdominal operation were divided into observation group （n =28, associated with infection of abdominal cavity） and control group （n =28） at random. The change of TNF, IL - 6 and IL - 8 in venous blood was tested for both groups by radioimmunonssay preoperatively and postoperatively. Results： The level of TNF, IL - 6 and IL - 8 were higher in the observation group than that in the control group before operation （P 〈 0. 01 ）, the level of TNF, IL - 6 and IL - 8 were higher in the two groups one day after operation than what it was before operation （ P 〈 0. 05 ）. The level of TNF, IL - 6 and IL - 8 decreased apparently in the observation group 7 days after operation （P 〈 0. 01 ）. The analysis testified that there was relationship among The TNF, IL - 6 and IL - 8 in venous blood. Conclusion： The level of TNF, IL - 6 and IL - 8 in venous blood of patients with abdominal infection increased much evidently. The monitoring of the change of TNF, IL -6 and IL -8 can be regarded as the important indexes in the observation of the status of abdominal infection of senile patients with abdominal operation.