围手术期血清粒细胞集落刺激因子测定的临床意义  

Detection of Serum Granulocyte-Colony Stimulating Factor Perioperatively and Its Clinical Value

作　　者：周铮[1] 刘振文[1] 马凤蓉[2] 谭炜[1] 焦秋明 陈宝公[1] 杨士琨[1] 潘菊芬[2] 

机构地区：[1]天津市第一中心医院外科,300192 [2]天津医科大学免疫教研室 [3]天津市天和医院

出　　处：《天津医药》1997年第11期643-645,共3页Tianjin Medical Journal

基　　金：天津市卫生局资助课题

摘　　要：对58例感染手术患者(Ⅰ组)和55例非感染手术患者(Ⅱ组)在术前及术后第1、3、5天作血清中G-CSF测定,并与体温、血白细胞计数及分类作相关分析。结果表明:1.术前Ⅰ组血清G-CSF含量高,而Ⅱ组含量极微,两者差异有显著性。2.术后24小时Ⅰ、Ⅱ两组的G-CSF水千均升高.两组间差异无显著性,说明手术时的应激状态也可致G-CSF增高。3.术后第3天,Ⅱ组G-CSF水平迅速卜降,而Ⅰ组仍居高不上(P<0.05),直至术后第5天在无继发感染的情况下,下降并与Ⅱ组差异无显著性,说明感染所致G-CSF增高是随感染的持续而存在的。4.两组的G-CSF与其体温、白细胞数及中性粒细胞数均明显相关(均P<0.05),而G-CSF的变化出现更早、更明显。综上提示,血清中G-CSF的检测可考虑用于早期判定于术后有无感染,从而指导临床合理使用抗生素。Serum granulocyte-colony stimulating factor (G-CSF) levels of 58 infected operation patients (group Dand 55 non-infected operation patients(group Ⅱ) were detected before operation and the first, third and fifith day after operation. The temperature,white blood cell count and differential blood count were measured at the same time for comparison. The results showed that:l. In perioperation significantly high levels of serum G-CSF were detected in group I patients while only minimal amount were obtained in group Ⅱ patients (P<0. 05). 2. In 24 hours after operation,both 2 groups of patients had similar high levels of serum G-CSF(P>0. 05) (indicating that high serum G-CSF couid also appear in stress caused by operation. 3. On the third day after operation, G-CSF levels in group Ⅱ rapidly dropped down while in group Ⅰ maintained in high levels(P<0. 05) ,and decreased to low levels on day 5 after operation if there was no existent secondary infection, indicating that the sustainable high levels of serum G-CSF were usually caused by infection. 4. The G-CSF levels was correlated to the temperature, WBC and neutrophil counts(P<0. 05) ,and the change of G-CSF appeared earlier and more significant. It is suggested that the detection of serum G-CSF may be useful for identifying infection in periop-erative period and for guiding clinician to use antibiotics more reasonably.

关 键 词：围手术期 血清 粒细胞 集落刺激因子 G-CSF 测定 

分 类 号：R619[医药卫生—外科学]