上尿路感染性结石行经皮肾取石手术前后对IL-2、IL-6和TNF的影响  

Effects of IL-2, IL-6 and TNF before and after percutaneous nephrolithotomy in patients with cal-culus of upper urinary tract infection

作　　者：王宏业[1] 尉继伟[2] 耿建[3] 

机构地区：[1]大同大学附属医院基本外科,山西大同037005 [2]大同大学附属医院泌尿外科,山西大同037005 [3]大同大学附属医院核医学科,山西大同037005

出　　处：《中国实用医刊》2013年第23期38-39,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨上尿路感染性结石行微创经皮肾取石手术前后对白细胞介素-2（IL-2）、白细胞介素石（IL-6）和肿瘤坏死因子（TNF）的影响，了解患者机体的抗炎免疫状态。方法选择行微创经皮肾取石术的上尿路感染性结石患者36例为观察组，另外选择门诊健康体检合格者30例作为对照组，测定并比较两组术前、术后24h、术后7d的IL-2、IL-6、TNF水平。结果观察组术前IL-2水平为（3．23±1．26）ng／ml，稍低于对照组的（3．80±1．32）ng／ml，但两组比较差异无统计学意义（P=0．0780）；术后24h[（1．75±1．14）ng/ml]显著低于对照组（P=0．0000）；术后7d[（3．98±2．24）ng／m1]略高于对照组，但差异无统计学意义（P=0．6998）。观察组术前IL-6水平为（0．64±0．16）ng／ml，显著高于对照组的（0．32±0．24）ng/ml，P=0．0000；术后24h[（1．97±0．78）ng／ml，P=0．0000]显著升高，术后7d[（0．56±0．36）ng/ml，P=0．0027]仍显著高于对照组。观察组术前TNF为（35．88±2．13）fmoL／ml，高于对照组的（26．12±1．12）fmol／ml，P=0．0（300；术后24h[（57．88±3.14）fmol／ml，P=0．0000]显著升高，术后7d[（30．78±1．33）fmo]／ml，P=0．0000]仍高于对照组。结论上尿路感染性结石有一定程度的免疫抑制，行微创经皮肾取石术免疫抑制在术后24h明显增加，其后逐渐恢复。Objective To investigate the effects of IL-2, 1L-6 and TNF before and after percuta- neous nephrolithotomy in patients with calculus of upper urinary tract infection, and to understand the change of immune state in the patients. Methods Thirty-six patients with calculus of upper urinary tract infection underwent the minimally invasive percutaneous nephrolithotomy were selected, and 30 health con-trois were selected as the control group, IL-2, IL-6 and TNF levels were measured and compared before surgery, 24 hours and 7 days after operation. Results Compared with the control group, the level of IL-2 before the operation was slightly lower （P = 0. 0780）, 24 hours after the operation was significantly lower （P =0. 0000）, and 7 days after the operation was slightly higher（P =0. 6998） ; the level of IL-6 before the operation was significantly higher （P = 0. 0000） , 24 hours after the operation was significantly increased （P =0. 0000）, and 7 days after operation was still significantly higher（P =0. 0027） ; The level of TNF be-fore the operation was higher（P =0. 0000）, 24 hours after the operation was significantly increased （P = 0. 0000）, and 7 days after the operation was higher（P =0. 0000）. Conclusions Calculus of upper urinary tract infection have degree of immunosuppression, the immune suppression of minimally invasive percutane-ous nephrolithotomy increased significantly in 24 hours after the operation, and then restored gradually.

关 键 词：上尿路感染性结石 经皮肾取石 细胞因子 

分 类 号：R699.2[医药卫生—泌尿科学]