腹腔引流液中的细胞因子在早期预测结直肠癌术后肠梗阻中的作用  

Cytokines in abdominal exudate to predict postoperative ileus following colorectal carcinoma surgery

作　　者：朱鹏程[1] 梁中林[1] 崔龙[1] 

机构地区：[1]上海交通大学医学院附属新华医院肛肠外科,上海200092

出　　处：《结直肠肛门外科》2013年第2期69-72,共4页Journal of Colorectal & Anal Surgery

基　　金：上海市科委基础研究重点项目(10DJ1400504)

摘　　要：目的检测结直肠癌手术后患者腹腔引流液中细胞因子水平,研究能否通过观察细胞因子水平的变化早期诊断术后肠梗阻。方法我们选择了100例行乙状结肠癌或直肠癌根治术的患者,在术后第1、3、5d提取患者的腹腔引流液,检测IL-1β,IL-6和TNF-α水平。结果有8位患者在术后第10～15d出现肠梗阻,两组患者术后第1d和第3d的IL-1β、IL-6和TNF-α水平变化不明显,无统计学差异。但是,在术后第5d,肠梗阻组的IL-1β、IL-6和TNF-α水平明显升高,而非肠梗阻组的IL-1β、IL-6和TNF-α水平明显下降。总体来说,非肠梗阻组的92例患者的细胞因子水平在术后前5d呈下降趋势,而肠梗阻组的8例患者的细胞因子水平呈明显上升趋势。结论结直肠癌术后患者腹腔引流液中IL-1β、IL-6和TNF-α水平的升高可能是一项早期预测术后肠梗阻的实验室指标。Objective To ble for an early diagnosis investigate whether measure of postoperative ileus （POI） ment of cytokines from abdominal exudate is valua following colorectal surgery. Methods One hundred consecutive patients who were scheduled to undergo elective resection for carcinoma of the sigmoid or rec-tum were investigated. Abdominal exudate was obtained from a drain tube after surgery for detection of interleukin （IL）-1β, IL-6 and tumour necrosis factor （TNF）-α. The relationship between cytokine levels at postoperative day 1, 3 and 5 and the development of POI was investigated. Results Eight patients devel oped POI, which was diagnosed on postoperative day 10 15. Peritoneal cytokine levels on postoperative days 1 and 3 were not significantly different between the 8 patients who developed POI and 92 patients who did not. In contrast, the cytokine levels on day 5 were significantly higher in patients who developed POI as compared with patients who did not. The cytokines signifi cantly increased during the first 5 days in pa-tients who developed POI, while signifi candy decreased in patients who did not. Conclusion The results of this investigation showed that the rise in peritoneal IL-1β, IL-6 and TNF a levels may be an additional ear-ly diagnostic predictor of POI following colorectal surgery.

关 键 词：肠梗阻 结直肠癌手术 细胞因子 

分 类 号：R735.3[医药卫生—肿瘤]