选择性脾胃区减断分流术对血清IL-4,IL-6和sIL-2R水平的影响

Effect of selective decongestive devascularization shunt of gastrosplenic region (SDDS-GSR) on the serum levels of IL-4,IL-6 and sIL-2R

目的探讨门静脉高压症脾功能亢进患者行选择性脾胃区减断分流术(selective decongestive devascularization shunt of gastrosplenic region,SDDS-GSR)后血清白介素-4(Interleukin-4,IL-4)、白介素-6(Interleukin-6,IL-6)和游离白介素-2受体(soluble interleukin-2 receptor,sIL-2R)水平的变化及意义。方法ELISA法检测8例SDDS-GSR术后1～3年门脉高压症患者血清IL-4,IL-6和sIL-2R水平,并与正常人及门脉高压症非手术患者作对照研究。结果门脉高压症非手术患者血清IL-4,IL-6和sIL-2R水平分别为(15.67±3.15)pg/ml,(3.16±1.30)pg/ml和(161.03±30.61)pg/ml,较正常组显著升高(P<0.01),SDDS-GSR术后IL-6,sIL-2R水平分别为(2.11±0.59)pg/ml和(124.98±36.93)pg/ml,较非手术组降低有统计学意义(P<0.05),但仍显著高于正常组(P<0.05)。结论IL-6和sIL-2R的分泌调节紊乱在肝硬化发病机制中起重要作用,SDDS-GSR术可有效缓解脾亢,显著降低患者血清IL-6和sIL-2R水平,表明有利于肝功能的维护和缓解肝硬化进展。

To explore the changes of the serum levels of IL-4,1L-6 and slL-2R after selective decongestive devascularization shunt of gastrosplenic region （SDDS-GSR）, and analyze the clinical significance. Methods The serum levels of IL-4,1L-6 and slL-2R were determined from 1 to 3 years after SDDS-GSR in 8 patients（SDDS-GSR group） and compared with the levels of healthy individuals （normal group） and the patients of cirrhotic hypersplenism without any operation （non-operation group）. Results The levels of IL-4,IL-6 and sIL-2R in the non-operation group were （15.67：1：3.15） pg/ml, （3.16＋1.30） pg/ml and （161.03~30.61） pg/ ml, respectively and higher than those in normal group（P〈0.01）. Compared with non-operation group, however, the levels of IL-6,slL-2R were markedly reduced to （2.11±0.59） pg/ml and （124.98±36.93） pg/ml in SDDS- GSR group （P〈0.05）. Conclusions The adjustment of IL-6 and slL-2R plays an important role in the pathogenesis of hepatic cirrhosis. SDDS-GSR can relieve hypersplenism, markedly reduce the serum levels of IL-6 and slL-2R, which indicates that SDDS-GSR can relieves the development of hepatic cirrhosis and is protious Rood for the maintenance of liver function.