肾下腹主动脉瘤切除重建术围手术期血浆白介素-6水平的变化

Changes in plasma interleukin-6 concentration followed infrarenal aortic aneurysm reconstruction

目的观察肾下腹主动脉瘤切除重建术患者围手术期血浆IL-6水平的变化。方法10例接受肾下腹主动脉瘤(ab-dominal aortic aneurysm,AAA)切除重建术和10例接受其他开腹大手术的患者,分别在全身麻醉诱导后以及术后6、12、24和48h抽取上肢静脉血标本,低温离心后取上清冻存,以双抗体夹心ABC-ELISA法定量测定血浆IL-6水平。结果与诱导后测得的血浆IL-6基础值相比,AAA手术组患者术后6h即有血浆IL-6水平的显著升高,与基础值相比,差异有统计学意义(P<0.05)。这一变化在术后12h达到顶峰,然后逐渐回落,在术后48h回落到基础值水平,差异无统计学意义(P>0.05)。开腹手术组术后各时间点所测得的血浆IL-6水平与该组诱导后所测得的基础值相比,差异无统计学意义(P>0.05)。结论肾下AAA切除重建术患者术后血浆IL-6水平显著升高,与阻断-开放腹主动脉相关的缺血-再灌注损伤可能是其主要原因。

Objective To determine the changes in plasma interleukin-6 （IL-6） concentration followed infratenal aortic aneurysm reconstruction. Methods Blood was sampled from the upper limb vein of 10 patients （Group A） undergoing elective AAA repair and other 10 patients （Group B） undergoing elective major abdominal surgery at five time points （after anesthesia induction and 6, 12, 24, 48 hours after surgery）. All samples were centrifuged and snap-frozen for subsequent batch analysis of IL-6 with ABC- ELISA. Results Compared with baseline IL-6 level （after anesthesia induction）, all patients in group A had an increased IL-6 level in plasma concentration at 6, 12, 24 hours time points （P〈0.01）, which peaked at 12 hours time point and went back to its baseline level at 48 hours time point. Similar findings were not found in group B. All patients in this group had a relatively steady IL- 6 level （compared with baseline level, P〈0.05）. Conclusion Plasma interleukin-6 increased after surgery in infrarenal AAA patients, this may be related to the ischemia/reperfusion attack followed aortic clamp/release.