炎性细胞因子在腹部或盆腔恶性肿瘤术后急性下肢深静脉血栓形成中的意义  

The clinical significance of inflammatory cytokines in acute lower extremity deep venous thrombosis developed in hospitalized postoperative patients with abdominal/pelvic malignancies

作　　者：王越华[1] 陈德杰[2] 郑颖[3] 肖天林[1] 刘晖杰[1] 刘晓洪[1] 邱慧斌[1] 袁佳[1] 刘曾[1] 

机构地区：[1]湖北省襄阳市中心医院肿瘤科,湖北襄阳441021 [2]湖北省襄阳市中心医院普外科,湖北襄阳441021 [3]湖北省襄阳市中心医院检验科,湖北襄阳441021

出　　处：《肿瘤》2013年第3期280-284,共5页Tumor

摘　　要：目的:探讨炎性细胞因子(C反应蛋白、白细胞介素6、白细胞介素10、核因子κB和E选择素)与腹部或盆腔恶性肿瘤患者术后发生急性下肢深静脉血栓(deep vein thrombosis,DVT)之间的关系。方法:本研究收集腹部或盆腔恶性肿瘤术后初发急性下肢DVT患者(40例,A组)的血清样本,测定血清C反应蛋白、白细胞介素6、白细胞介素10、E选择素和核因子κB水平,并与腹部或盆腔良性疾病术后发生急性下肢DVT的患者(20例,B组)、腹部或盆腔恶性肿瘤术后未发生急性下肢DVT的患者(40例,C组)以及健康体检人群(40例,D组)的上述指标进行比较。结果:与D组相比,A、B和C组的血清C反应蛋白、白细胞介素6、白细胞介素10、核因子κB和E选择素水平明显升高(P<0.01)。A、B和C组的血清C反应蛋白水平无明显差异(P>0.05)。A组血清白细胞介素6、核因子κB和E选择素水平明显高于B和C组(P<0.05),A组血清白细胞介素10水平明显低于B和C组(P<0.05)。结论:血清C反应蛋白水平不能作为腹部或盆腔恶性肿瘤术后发生急性下肢DVT的早期预测指标,而血清白细胞介素6、核因子κB和E选择素水平则可作为腹部或盆腔恶性肿瘤术后发生急性下肢DVT的早期预测指标。Objective： To explore the association of inflammatory cytokines including CRP （C-reactive protein）, IL-6 （interleukin 6）, IL-10 （interleukin 1 0）, NF-κB （nuclear factor-kappa B） and Es （E-selectin） with acute lower extremity DVT （deep venous thrombosis） developed in hospitalized postoperative patients with abdominal/pelvic malignancies. Methods： Serum samples were obtained to examine the serum levels of CRP,IL-6, IL-10, NF-κB and Es in hospitalized postoperative patients with abdominal/pelvic malignancies who initially developed acute lower extremity DVT （group A, n = 40）, and these serum cytokine levels of group A were compared with those of hospitalized postoperative patients with abdominal/pelvic benign diseases who also developed acute lower extremity DVS （group B, n = 20）, the hospitalized postoperative patients with abdominal/pelvic malignancies who did not develop acute lower extremity DVS （group C, n = 40）, and the healthy subjects who volunteered as normal controls （group D, n = 20）. Results： The serum levels of CRP, IL-6, IL-10, NF-KB and Es in group D were significantly lower than those in groups A, B and C （P 〈 0.01 ）. There was no significant difference in CRP level among groups A, B and C （P 〉 0.05）. The serum levels of IL-6, NF-κB and Es in group A were significantly higher than those in groups B and C （P 〈 0.05）. The serum level of IL-10 in group A was significantly lower than those in groups B and C （P 〈 0.05）. Conclusion： Serum CRP level may not be used as an early predictor for the diagnosis of acute lower extremity DVT developed in hospitalized postoperative patients with abdominal/pelvic malignancies, but the serum IL-6, NF-κB and Es levels can be used as early predictors for this diagnosis.

关 键 词：腹部肿瘤 静脉血栓栓塞 外科手术 细胞因子类 

分 类 号：R730.6[医药卫生—肿瘤]