腹部大手术患者血浆ALB变化与患者炎症反应的关系

Relationship between Plasma ALB Changes and Inflammatory Response in Patients with Abdominal Surgery

探讨腹部大手术患者血浆白蛋白(ALB)水平变化与患者炎症反应程度的关系。选取在我院实施腹部手术的120例患者(2013年8月至2016年12月)进行研究,根据POSSUM生理学评分将患者分为大手术组(POSSUM手术创伤评分≥11分)68例、非大手术组52例(POSSUM手术创伤评分<11分),对比两组患者术前、术后24 h、术后48 h、术后72 h的血浆ALB、血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)的水平,并采用线性相关分析法探讨血浆ALB与血清炎症因子的关系。结果显示术前,大手术组患者与非大手术组患者血浆ALB水平无显著差异(p>0.05),经历大手术组的患者在术后3个时间段24 h、48 h、72 h的血浆ALB显著的低于非大手术组患者,差异具有统计学意义(p<0.05);术前,大手术组患者与非大手术组患者血清IL-6水平无明显差异(p>0.05),经历大手术组的患者在术后3个时间段24 h、48 h、72 h的血清IL-6、TNF-α、IL-8水平显著的高于非大手术组患者,差异具有统计学意义(p<0.05)。结果表明腹部大手术患者血浆ALB水平降低更为显著,并且与患者炎症反应程度呈显著的负相关性。

The aim of this study was to investigate the relationship between plasma albumin（ALB） levels and inflammatory response in patients with abdominal surgery. 120 patients who underwent abdominal surgery from August 2013 to December 2016 were enrolled in this study, and they were divided into 68 cases of large operation groups（POSSUM surgical trauma score≥11） and 52 cases in non large operation group（POSSUM surgical trauma score〈11） according to the POSSUM physiology score. The levels of plasma ALB, serum interleukin-6（IL-6）,tumor necrosis factor（TNF-α） and interleukin-8（IL-8） were compared before operation, after operation of 24 h,48 h and 72 h, and linear correlation analysis were used to explore the relationship between plasma ALB and serum inflammatory factors. The result showed that there was no significant difference in plasma ALB between large operation group and non large operation group before operation（p〉0.05）. After treatment, the plasma ALB of the patients in large operation group at postoperative 24 h, 48 h, and 72 h was significantly lower than that in the non-large, which was statisticallt significant（p〈0.05）. There was no significant difference in serum IL-6 level between the operation group and the non-operation group before operation（p〉0.05）. The levels of serum IL-6, TNF-αand IL-8 were significantly higher than those of non-operation group at postoperative 24 h, 48 h, and 72 h（p〈0.05）.The decrease of plasma ALB level in patients with abdominal surgery was more significant and was negatively correlated with the degree of inflammatory response.