术前胆道引流对恶性阻塞性黄疸患者免疫、炎症状况的影响  

Influence of preoperative biliary drainage in immune and inflammation of malignant obstructive jaundice patients

作　　者：邹远航[1] 马涛[1] 贾乾斌[2] 

机构地区：[1]汕头大学医学院附一院肝胆外科,广东汕头515041 [2]四川大学华西医院胆道外科,四川成都610041

出　　处：《中国医药导报》2011年第8期51-52,共2页China Medical Herald

摘　　要：目的:探讨术前胆道引流对恶性阻塞性黄疸患者免疫、炎症状况的影响。方法:选择于我院2008年6月～2010年3月就诊的43例恶性阻塞性黄疸患者作为研究对象,对患者进行术前胆道引流,以白细胞介素6(IL-6)、白细胞介素8(IL-8)、肿瘤坏死因子α(TNF-α)、CD4+、CD8+、C反应蛋白(CRP)为观察,指标比较引流前后患者的免疫、炎症状况。结果:引流后患者的IL-6、IL-8、、CD4+、CD8+、CRP分别为(40.8±7.0)ng/L、(1.37±0.26)μg/L、(34.7±3.0)、(28.±2.3)、(29.5±1.8)×103 mg/L,与引流前的(40.5±7.3)ng/L、(1.39±0.24)μg/L、(34.4±3.2)、(28.3±2.5)、(29.0±2.2)×103 mg/L比较,差异均无统计学意义(t=0.194 5、0.370 6、0.448 5、0.386 1、1.153 4,均P>0.05);引流后患者的TNF-α为(1.05±0.23)μg/L,与引流前的(1.42±0.25)μg/L比较,差异有统计学意义(t=7.1422,P<0.05)。结论:术前胆道引流恶性阻塞性黄疸能够明显改善患者的TNF-α水平,TNF-α是恶性阻塞性黄疸患者免疫、炎症的敏感因子,值得临床关注。Objective： To explore the influence of preoperative biliary drainage in immune and inflammation of malignant obstructive jaundice patients. Methods： From June 2008 to March 2010 in our hospital, 43 patients of malignant obstructive jaundice were selected and as the research subjects, they were treated with preoperative biliary drainage, Interleukin 6 （IL-6）, Interleukin 8 （IL-8）, tumor necrosis factor α（TNF-α）, CD4＋, CD8＋, C-reactive protein （CRP） were used as the indicator, the immune and inflammation conditions were observed before and after drainage. Results： After drainage, IL-6, IL-8, CD4＋, CD8＋, CRP of patients were （40.8±7.0） ng/L, （1.37±0.26） μg/L, （34.7±3.0）, （28.5±2.3）, （29.5±1.8）×103 mg/L, compared with （40.5±7.3） ng/L, （1.39±0.24） μg/L, （34.4±3.2）, （28.3±2.5）, （29.0±2.2）×10^3 mg/L before drainage, the differences were not statistically significant （t=0.1945, 0.3706, 0.4485, 0.3861, 1.1534, all P〉0.05）; after drainage, TNF-α drainage of patients was （1.05±0.23） μg/L, compared with （1.42±0.25） μg/L before drainage, the difference was statistically significant （t=7.1422, P〈0.05）. Conclusion： Preoperative biliary drainage in malignant obstructive jaundice can significantly improve patients‘ TNF-α level, TNF-α is a sensitive factor of immune and inflammation of malignant obstructive jaundice patients, and is worthy of attention.

关 键 词：恶性阻塞性黄疸 胆道引流 免疫 炎症 

分 类 号：R575[医药卫生—消化系统]