术前胆道引流对恶性阻塞性黄疸患者炎症因子和免疫功能的影响

Effect of preoperative biliary drainage for malignant obstructive jaundice patients with inflammatory cytokines and immune function

目的探讨术前胆道引流(Preo Perative Biliary Drainage,PBD)对恶性阻塞性黄疸患者炎症因子和免疫功能的影响。方法将61例恶性阻塞性黄疸患者随机分为PBD组(31例)和NPBD组(30例),PBD组患者采用术前胆道引流处理,NPBD组不作引流处理,观察两组患者引流前后炎症因子(白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α))和免疫功能指标(CD4+、CD8+、C反应蛋白(CRP))变化情况。结果两组患者引流前炎症因子和免疫功能指标无统计学差异(P﹥0.05),PBD组患者引流后TNF-α指标显著低于NPBD组(0.78±0.14)ug/Lvs(1.57±0.27)ug/L,P﹤0.05),其余炎症因子和免疫功能指标均无统计学差异(P﹥0.05)。结论对恶性阻塞性黄疸患者行术前胆道引流,患者体内炎症因子TNF-α指标显著降低,其余炎症因子和免疫功能指标无显著改变。

Objective To explore the effects of preoperative biliary drainage （PreoPerative Biliary Drainage, PBD） in malignant obstructive jaundice patients and its influence on inflammatory cytokines and immune function. Methods 61 cases of patients with malignant obstructive jaundice were randomly divided into PBD group （31 cases） and NPBD group （30 cases）, PBD group were treated by preoperative biliary drainage, NPBD group without drainage, drainage of inflammatory factor （interleukin 6 （IL-6）, interleukin 8 （IL-8）, tumor necrosis factor alpha （TNF-alpha）） And immune function（CD4＋, CD8＋, C reactive protein （CRP）） of two groups were observed before and after the drainage. ResuRs there were no statistical difference between the drainage of proinflammatory cytokines and immune function indexes in two groups （P〉0.05）, TNF- alpha index drainage group PBD patients was significantly lower than those in group NPBD （0.78±0.14） ug/L vs （1.57±0.27） ug/L, （P〈0.05）, There were no statistical difference between the rest of inflammatory factors and immune function indexes （P〉0.05）. Conclusion in patients with malignant obstructive jaundice of preoperative biliary drainage, the inflammatory factor TNF-alpha index decreased significantly, There are no significant change in the rest of inflammatory factors and immune function indexes.