血清CRP、IL-6、IL-10联合检测诊断腹腔镜结直肠癌术后吻合口瘘的价值分析  

The value analysis of serum CRP,IL-6 and IL-10 combined detection in diagnosis of anastomotic fistula after laparoscopic colorectal cancer surgery

作　　者：明涛 胡俊君 查锋 MING Tao;HU Jun-jun;ZHA Feng(Department of General Surgery,Wuhan Seventh Hospital,WuHan 430071,China)

机构地区：[1]武汉市第七医院普通外科,430071

出　　处：《中国实用医药》2023年第7期12-16,共5页China Practical Medicine

摘　　要：目的分析血清C反应蛋白(CRP)、白细胞介素(IL)-6、IL-10联合检测诊断腹腔镜结直肠癌术后吻合口瘘的临床价值。方法117例行腹腔镜手术治疗的结直肠癌患者,根据术后是否出现吻合口瘘分为吻合口瘘组(15例)和非吻合口瘘组(102例)。两组均采用免疫比浊法检测血清CRP水平,采用放射免疫法检测血清IL-6水平,采用酶联免疫吸附法检测血清IL-10水平。比较两组患者不同时间点血清CRP、IL-6、IL-10水平,采用受试者工作特征(ROC)曲线分析单一及联合检测诊断吻合口瘘的价值。结果术后3、4、5、6、7 d,吻合口瘘组患者血清CRP水平分别为(74.50±12.17)、(84.07±14.56)、(93.25±17.18)、(90.14±15.44)、(78.32±11.23)mg/L,均明显高于非吻合口瘘组的(50.74±9.34)、(44.18±7.92)、(39.94±6.73)、(31.63±4.97)、(25.03±3.65)mg/L,差异具有统计学意义(P<0.05)。吻合口瘘组患者血清CRP水平在术后5 d达到最高峰值,而非吻合口瘘组患者术后3 d即达到最高峰值。术后3、4、5、6、7 d,吻合口瘘组患者血清IL-6水平分别为(103.77±15.68)、(81.38±12.64)、(75.05±10.21)、(63.21±8.53)、(54.22±7.33)ng/L,均明显高于非吻合口瘘组的(71.43±10.29)、(63.46±9.15)、(51.24±7.87)、(43.36±6.07)、(34.16±5.42)ng/L,差异具有统计学意义(P<0.05)。两组患者血清IL-6水平均在术后3 d均达到最高峰值。术后3、4、5、6、7 d,吻合口瘘组患者血清IL-10水平分别为(24.35±3.12)、(26.89±3.75)、(28.87±4.12)、(30.61±5.02)、(34.14±5.92)ng/ml,均明显低于非吻合口瘘组的(28.57±3.91)、(30.62±4.17)、(33.94±4.56)、(35.27±5.74)、(39.05±6.11)ng/ml,差异具有统计学意义(P<0.05)。两组患者血清IL-10水平在术后3 d均达到最低值。ROC曲线分析显示:术后5 d CRP+术后3 d IL-6+术后3 d IL-10联合检测的曲线下面积(AUC)、灵敏度及特异度均高于术后5 d CRP、术后3 d IL-6、术后3 d IL-10单一检测。结论术后5 d CRP、术后3 d IL-6和IL-Objective To analyze the clinical value of serum C-reactive protein(CRP),interleukin(IL)-6 and IL-10 combined detection in diagnosis of anastomotic fistula after laparoscopic colorectal cancer surgery.Methods 117 colorectal cancer patients receiving laparoscopic surgery were divided into anastomotic fistula group(15 cases)and non-anastomotic fistula group(102 cases)according to whether anastomotic fistula occurred after surgery.In both groups,serum CRP level was measured by immunoturbidimetric method,serum IL-6 level by radioimmunoassay and serum IL-10 level by enzyme-linked immunosorbent assay.Serum levels of CRP,IL-6 and IL-10 of the two groups at different time points were compared,and the receiver operating characteristic(ROC)curves were used to analyze the value of single and combined detection in diagnosis of anastomotic fistulas.Results At 3,4,5,6,and 7 d postoperatively,the serum CRP levels of patients in the anastomotic fistula group were(74.50±12.17),(84.07±14.56),(93.25±17.18),(90.14±15.44),and(78.32±11.23)mg/L,which were significantly higher than those of(50.74±9.34),(44.18±7.92),(39.94±6.73),(31.63±4.97),and(25.03±3.65)mg/L in the non-anastomotic fistula group,and the differences were statistically significant(P<0.05).Serum CRP levels peaked at 5 d postoperatively in the anastomotic fistula group,whereas they peaked at 3 d postoperatively in the non-anastomotic fistula group.At 3,4,5,6,and 7 d postoperatively,the serum IL-6 levels of patients in the anastomotic fistula group were(103.77±15.68),(81.38±12.64),(75.05±10.21),(63.21±8.53),and(54.22±7.33)ng/L,which were significantly higher than those of(71.43±10.29),(63.46±9.15),(51.24±7.87),(43.36±6.07),and(34.16±5.42)ng/L in the non-anastomotic fistula group,and the differences were statistically significant(P<0.05).Serum IL-6 levels reached their highest peak at 3 d postoperatively in both groups.At 3,4,5,6,and 7 d postoperatively,the serum IL-10 levels of patients in the anastomotic fistula group were(24.35±3.12),(26.89±3.75),(28

关 键 词：腹腔镜 结直肠癌 吻合口瘘 C反应蛋白 白细胞介素 

分 类 号：R735.34[医药卫生—肿瘤]