直肠癌患者术后疼痛程度与血清补体C3、C4水平的相关性分析

The trend of variation and relationship of postoperative pain and serum complement C3 and C4 in cancer patients undergoing rectum surgery

目的探讨直肠癌患者术后疼痛程度与血清补体C3、C4水平的变化趋势及两者相关性。方法选择择期行直肠癌根治术患者100例,视觉模拟量表(VAS)评分测量患者术前12h及术后4、8、12、24、48、72、120h疼痛强度;同一时点采集患者外周静脉血,采用免疫比浊法测定血清补体系统中C3、C4含量。结果与术前12h比较,患者的VAS评分在术后4、8、12、24、48、72h明显增高(P<0.01);术后120h恢复至术前水平。与术前12h比较,患者术后的血清C3、C4水平在术后4、8、12、24、48h明显降低(P<0.01),术后72h恢复至术前水平。VAS分值与血清补体C3水平呈明显负相关(r=-0.622,P<0.01),与血清补体C4水平亦呈明显负相关(r=-0.649,P<0.01)。结论术后疼痛能激活血清中的补体系统,降低血清补体C3、C4水平,从而抑制机体的免疫反应。

Objective To explore the trend of variation and relationship of postoperative pain and serum complement C3 and C4in cancer patients undergoing rectum surgery.Methods 100 patients,who were scheduled for rectum carcinoma surgery,were selected to the study.Pain was assessed by a visual analog scale at 12 hbefore operation and 4,8,12,24,48,72,120 hafter surgery.The blood samples were obtained at the same time.The contents of serum complement C3 and C4were determined by immunoturbidimetry.Results The VAS values in 4,8,12,24,48,72hpost-operation were significantly higher than 12hpre-operation（P〈0.01）,and in 120hpost-operation returned to 12hpre-operation level.Compared with 12hpre-operation,the contents of serum complement C3 and C4in 4,8,12,24,48hpost-operation were significantly decreased（P〈0.01）.The contents of serum complement C3 and C4returned to 12hpre-operation level in 72hpost-operation.The results of correlative study on VAS values and the contents of serum complement C3 showed a negative correlation（r=-0.622,P〈0.01）.The results of correlative study on VAS values and the contents of serum complement C4 also showed a negative correlation（r=-0.649,P〈0.01）.Conclusion Postoperative pain can induce complement activation,reduce the levels of serum complement C3 and C4,and inhibit immunoreactions.