尿白细胞介素18在腹腔热灌注化疗中的表达与血肌酐、尿素氮相关性的探讨  

A discussion on the expression of the Urine interleukin 18 on abdominal cavity perfusion chemotherapy and its correlation with serum creatinine and blood urea nitrogen

作　　者：李建华[1] 赵宏娟[2] 赵广平[1] 甄书青[1] 白玉伟[1] 陈永学[1] 

机构地区：[1]邯郸市中心医院麻醉科,河北邯郸056002 [2]邯郸职业技术学院门诊部,河北邯郸056001

出　　处：《临床和实验医学杂志》2016年第23期2353-2356,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的研究尿白细胞介素18（IL-18）在腹腔热灌注化疗围术期中的表达及与血肌酐（SCr）、尿素氮（BUN）的相关性。方法选择20例行腹腔热灌注手术患者,根据既往有无肾脏疾病病史的患者,分为有肾脏疾病病史组（Y组）10例,无肾脏疾病病史组（Z组）10例。两组均采用静吸复合全身麻醉下使用（43.0±0.5）℃温盐水腹腔循环热灌注化疗药物60 min,于术前1 h（T0）、热灌注30 min（T1）、热灌注60 min（T2）、术后8 h（T3）、12 h（T4）、24 h（T5）、48 h（T6）收集各时间点尿液6-8 ml采用酶联免疫吸附法（ELISA）,测量IL-18的水平。同时抽取静脉血测定SCr、BUN水平。同时记录两组鼻咽温度、无创袖带平均动脉压（MAP）、动脉血氧分压（Pa O2）及48 h输液总量和尿量。结果与T0时比较,两组IL-18浓度均在T1时升高,SCr、BUN值在T2时升高,均在T4时达峰值。T5时Y组IL-18、Scr、BUN值仍高于T0（P〈0.05）,、T6下降至T0水平。与Z组比较,Y组IL-18值T1、T2、T3、T4、T5时刻明显高于Z组（P〈0.05）,Y组SCr、BUN值T2、T3、T4、T5时刻明显高于Z组（P〈0.05）。两组鼻咽温、Pa O2在T1、T2时升高差异有统计学意义（P〈0.05）。两组MAP及输液总量（48 h）和尿量（48 h）组间比较无明显差异（P〉0.05）。结论尿IL-18在对既往有肾脏疾病病史的腹腔热灌注化疗患者手术中对肾脏的急性损伤具有早期检测意义,IL-18与SCr、BUN具有一定相关性。Objective To study the relationship between the expression of urine interleukin 18（ IL- 18） on abdominal cavity perfusion chemotherapy and its correlation with serum creatinine（ SCr） and urea nitrogen（ BUN）. Methods 20 cases routine abdominal hot perfusion surgery patients were selected,according to the patients with preoperative renal function tests,SCr,BUN,10 cases were divided into abnormal renal function group（ Y,n = 10）,and 10 cases into normal renal function group（ n = 10） Z group. Two groups adopted static absorption composite used under general anesthesia（ 43. 0 ± 0. 5） ℃ temperature brine circulation heat abdominal cavity perfusion chemotherapy drugs for 60 min. In 1h（ T0） before operation,30 min（ T1）,60 min（ T2）,after surgery 8 h（ T3）,12 h（ T4）,24 h（ T5）,48 h（ T6）,6 - 8 ml urine were collected,and enzyme- linked immunosorbent（ ELISA） was used to measure the levels of IL- 18,and venous blood was extracted to determine the level of SCr and BUN. Nasopharyngeal temperature,noninvasive cuff,mean arterial pressure（ MAP）,arterial blood oxygen partial pressure（ Pa O2） and 48 h transfusion volume and urine output were recorded. Results Compared with the T0,concentration of IL- 18 in two groups increased when T1,SCr and BUN were higher in T2,both reach peak in the T4. In T5,IL- 18,Scr and BUN of Y group values were still above the level of that in the T0 with statistical difference（ P〈0. 05）,and Z group no significant difference（ P〉0. 05）. Compared with Z group,in T1,T2,T3,T4,T5,T6,the level of IL- 18 in Y group were higher than those in Z group,SCr and BUN in T2,T3,T4,T5,T6 were higher than those in Z group with significant difference（ P〈0. 05）. Nasopharyngeal temperature and Sp O2 between the two groups were different. 48 h transfusion volume and urine have no significant difference between groups（ P〈0. 05）. Conclusion There is early detective value of Urinary IL- 18 in acute kidney injury patients who are given abdominal

关 键 词：急性肾损伤 尿白细胞介素18 腹腔热灌注化疗 血肌酐 尿素氮 相关性 

分 类 号：R730.5[医药卫生—肿瘤]