前列腺增生3种外科治疗方法血清IL--6和CRP的水平变化

Changes of the levels of Interleukin-6 and C-reactive protein following three surgical methods for BPH

目的 探讨前列腺增生 (BPH)的 3种外科治疗方法血清 IL- - 6和 CRP水平的变化 .方法 用前瞻、对比的临床实验 ,对 117例分别进行开放性手术 (OP)、经尿道气化电切术(TUEVAP)和组织间激光消融 (IL C)的 BPH患者 ,用酶联免疫吸附法 (EL ISA )检测其手术前后血清白细胞介素 - 6 (IL - 6 )和 C-反应蛋白 (CRP)水平 .结果 3组患者血清 IL- 6和 CRP水平术前无显著差异 ,但术后 2 4 h明显高于术前 (P<0 .0 5 ) ,其中以开放手术组最高 ,TUEVAP组次之 ,IL C组最低 ;术后2 4 h血清 IL - 6水平与手术时间、术中出血量明显相关 (r=0 .6 9,P=0 .0 0 0 0 ) ,术后 4 8h血清 CRP水平与手术时间相关 (r= 0 .83,P=0 .0 0 0 0 ) .结论 3种外科治疗方法中 ,开放性手术对机体的创伤最为严重 ,急性时相反应最大 ,经尿道气化电切术次之 ,组织间激光消融则最小 .

AIM To study the trauma degree of the patients undergoing open prostatectomy (OPEN), transurethral electrovaporisation albation prostatectomy (TUEVAP) or interstitial laser coagulation (ILC). METHODS One hundred and seventeen patients underwent surgical treatment: OPEN ( n =61), TUEVAP ( n =37) or ILC ( n =19). The serum parameters of interleukin 6 (IL 6) and C reactive protein (CRP) were measured by ELISA before and after the operative procedure. RESULTS The preoperative levels of both serum IL 6 and CRP showed no significant difference among the three groups. At 24 h after operation, the level of serum IL 6 became significantly higher than the preoperative level in all the groups ( P <0.05), with OPEN being the highest and ILC the lowest. IL 6 was positively correlated with the operative duration and blood loss ( r=0.69, P =0.0000) at 24 h after operation and CRP was positively correlated with the operative duration at 48 h after operation ( r=0.83, P= 0.0000 ). CONCLUSION Extent of tissue damage and the degree of acute phase reaction by OPEN are the severest and the least by ILC. Operative duration and blood loss are the main factors responsible for the tissue damage.