术前T淋巴细胞水平对脊柱手术后感染及血清促炎性细胞因子的影响  

Effect of preoperative T lymphocyte level on postoperative spinal infection and serum pro-inflammatory cytokines

作　　者：张树军 赵志刚[1] 胡骏 崔巍 谢威 王昕 宋升 孙振中 ZHANG Shujun;ZHAO Zhigang;HU Jun;CUI Wei;XIE Wei;WANG Xin;SONG Sheng;SUN Zhenzhong(Department of Spine Surgery,Wuhan Fourth Hospital,Hubei Province,Wuhan430030,China;Department of Spine Surgery,Wuxi Ninth People′s Hospital,Jiangsu Province,Wuxi214063,China)

机构地区：[1]湖北省武汉市第四医院脊柱外科,湖北武汉430030 [2]江苏省无锡市第九人民医院脊柱外科,江苏无锡214063

出　　处：《中国医药导报》2019年第33期78-81,共4页China Medical Herald

基　　金：湖北省知识创新专项(自然科学基金)项目(2018CFB713)

摘　　要：目的探讨术前T淋巴细胞水平对脊柱手术后感染及血清促炎性细胞因子的影响。方法选取2017年1月~2018年6月于湖北省武汉市第四医院进行脊柱手术的患者119例进行研究,将CD3^+<50%的患者设为观察组(60例),将CD3+≥50%的患者设为对照组(59例)。比较两组手术情况,手术前后肿瘤坏死因子α(TNF-α)、白细胞介素8(IL-8)、白细胞介素10(IL-10)及白细胞介素1β(IL-1β)水平变化情况,胃肠功能及术后感染发生情况。结果两组手术时间比较,差异无统计学意义(P>0.05);观察组出血量多于对照组,住院时间长于对照组(P<0.05);术前,观察组TNF-α、IL-8、IL-10及IL-1β显著高于对照组(P<0.05);术后,两组血清炎性因子水平均显著上升,且观察组高于对照组(P<0.05);术后,观察组患者肠鸣音消失、肛门排气、排便、恢复饮食及腹胀缓解时间均显著高于对照组(P<0.05);术后,观察组感染总发生率显著高于对照组(P<0.05)。结论脊柱手术患者术后感染与术前T淋巴细胞水平直接相关,术前T淋巴细胞水平低下者术后感染率较高,临床应针对患者的T淋巴细胞水平进行监测及改善。Objective To study the effect of preoperative T lymphocyte level on postoperative spinal infection and serum proinflammatory cytokines after spinal surgery.Methods From January 2017 to June 2018,119 patients who underwent spinal surgery in Wuhan Fourth Hospital of Hubei Province were selected for the study,patients with CD3^+<50%were set as the observation group(60 cases),and patients with CD3^+≥50%were set as the control group(59 cases).The operation conditions,the changes of tumor necrosis factorα(TNF-α),interleukin-8(IL-8),interleukin-10(IL-10),and interleukin-1β(IL-1β)levels before and after surgery,gastrointestinal function and postoperative infection were compared between the two groups.Results There was no significant difference in operation time between the two groups(P>0.05).The amount of bleeding in the observation group was more than that in the control group,and the length of hospitalization was longer than the control group(P<0.05).Before operation,the levels of TNF-α,IL-8,IL-10 and IL-1βin the observation group were significantly higher than those in the control group(P<0.05).After operation,the levels of serum inflammatory factors in the two groups were significantly increased,and the observation group was significantly higher than that in the control group(P<0.05).After operation,the disappearance of bowel sounds,anal exhaust,defecation,diet recovery and abdominal distension relief time in the observation group were significantly higher than those in the control group(P<0.05).After operation,the total incidence of infection in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Postoperative infection in patients with spinal surgery is directly related to the preoperative T lymphocyte level,and patients with low preoperative T lymphocyte level have a high postoperative infection rate.The T lymphocyte level of patients should be monitored and improved clinically.

关 键 词：术前 T淋巴细胞 脊柱手术 术后感染 炎症细胞 

分 类 号：R619.3[医药卫生—外科学]