老年腹股沟疝无张力修补术前后血清IL-17 IL-6及TIMP-2水平变化及临床意义

Clinical Significance and Changes of Serum IL-17 IL-6 and TIMP-2 Levels in Elderly Patients with Inguinal Hernia Before and After Tension-Free Hernioplasty

目的:观察老年腹股沟疝无张力修补术患者前后血清白介素17(IL-17)、白介素6(IL-6)及组织金属蛋白酶抑制剂(TIMP-2)水平变化,并分析其临床意义。方法:选取我院96例老年腹股沟疝病例为观察组,均行无张力修补术,并取同期47例体检健康者为对照组,比较对照组与观察组手术前后血清IL-17、IL-6、TIMP-2水平;依据术后并发症与复发情况分为预后良好组与预后不良组,比较两组与对照组血清IL-17、IL-6、TIMP-2水平,并行相关性分析。结果:血清IL-17、IL-6水平为:术后>术前>对照组(P<0.05),对照组<预后良好组<预后不良组(P<0.05);TIMP-2水平为:术后<术前<对照组(P<0.05),对照组>预后良好组>预后不良组(P<0.05);血清IL-17、IL-6与老年腹股沟疝无张力修补术患者预后呈负相关(P<0.05),血清TIMP-2与其预后呈正相关(P<0.05)。结论:相较于术前,老年腹股沟疝无张力修补术患者术后24h血清IL-17、IL-6水平明显升高,血清TIMP-2水平明显降低,其变化与预后紧密相关,可为临床治疗及预后评估提供有效指导。

Objective:To observe the changes in levels of serum interleukin-17(IL-17),interleukin-6(IL-6)and tissue inhibitor of metalloproteinase(TIMP-2)of elderly patients with inguinal hernia(IH)before and after tension-free hernioplasty(TFH),and to analyze their clinical significance.Methods:96 elderly IH patients in the hospital who had undergone TFH were enrolled as observation group,and 47 healthy controls in the same period were enrolled as control group.The levels of serum IL-17,IL-6 and TIMP-2 before and after surgery in the observation group were compared with those in the control group.According to different postoperative complications and recurrence,the patients were divided into good prognosis group and poor prognosis group.The levels of serum IL-17,IL-6 and TIMP-2 were compared between the two groups and control group and correlation analysis was conducted.Results:The levels of serum IL-17 and IL-6 after surgery were higher than those before surgery,which were higher than those in control group(P<0.05).Arranging levels of serum IL-17 and IL-6 from low to high,the corresponding order was control group,good prognosis group and poor prognosis group(P<0.05).TIMP-2 level after surgery was lower than that before surgery,which was lower than that in control group(P<0.05).TIMP-2 level was the highest in control group,followed by good prognosis group and poor prognosis group(P<0.05).Serum IL-17 and IL-6 were negatively correlated with prognosis of elderly IH patients undergoing TFH(P<0.05),while serum TIMP-2 was positively correlated with prognosis(P<0.05).Conclusion:Compared with those before surgery,at 24h after surgery,levels of serum IL-17 and IL-6 are significantly increased in elderly IH patients who have undergone TFH,while serum TIMP-2 level is significantly decreased.Their changes are closely related to prognosis,which can provide effective guidance for clinical treatment and prognosis assessment.