小儿围手术期外周血sIL-2R、TNF等细胞因子变化动态观察及临床意义

Changes of serum TNF and sIL-2R levels in children under operation and their clinical significance

目的 探讨可溶性白介素Ⅱ受体 (sIL - 2R)、肿瘤坏死因子 (TNF)、补体C3、C4等细胞因子与小儿手术、术后并发症的关系及对临床预后的指导意义。方法 放射免疫法、双抗夹心ELISA法及单向扩散法检测 15例小儿 (术前对照 )、接受手术患儿 64例 (分大、中、小手术组及术前、术后感染组 )围手术期各指标浓度。结果 ①大、中手术组sIL - 2R、TNF术前浓度术后 1d上升 (P <0 0 1)②围手术期大、中手术组sIL - 2R、TNF浓度高 (P <0 0 1) ,大手术组术后 7d恢复到术前水平 ,而中手术组术后 3d即恢复 ;C3、C4术后 1d下降 (P <0 0 1)术后 3d恢复正常。小手术组无变化。③术后感染组sIL - 2R、TNF浓度较无感染组高 (P <0 0 1)术后并发感染组sIL - 2R、TNF浓度术后持续升高至术后 7d仍不降 ,C3、C4保持低值。结论 上述细胞因子可为围手术期治疗及判断预后提供参考。

WT5”BZ] Objective To investigate the relation between operation, postoperative infection and soluble interleukin-2R (sIL-2R), tumor necrosis factor(TNF), complements 3 and 4 (C3,C4),and to provide help for judgment of prognosis. Methods Sixty four patients were divided into major, middle and minor groups, and pre and post operative infection groups, as well as 15 patients (control group) were involved. All of indexes were measured by ELISA and radioimmunoassay(RIA) in perioperative period. Results ① Preoperative serum TNF and sIL-2R levels of these children under major and middle operation were higher than those of control and minor groups( P <0 01).②During perioperative period, sIL-2R and TNF levels increased significantly ( P <0 01) in the patients under major and middle operation; C3 and C4 levels dereased significantly ( P <0 01). There was no significant changes in minor and control groups.③TNF and sIL-2R levels of postoperative infection group were higher than those of noninfection group ( P <0 01);TNF and sIL-2R levels of postoperative infection group increased significantly and remained high levels after seventh day; C3 and C4 remained lower. Conclusion These indexes may provide some help to judge the prognosis. [WT5”HZ]