食管癌患者胸段手术前后血清激素水平的变化及临床意义

目的：探讨食管癌患者胸段手术前后血清激素水平的变化及其测定的临床意义。方法：皮质醇（cortis01）、血清垂体泌乳素（pmlactin，PRL）、促甲状腺激素（thyroidstimulatinghormone，TSH）测定采用化学发光免疫分析；生长激素（growthhormone，GH）和血管紧张素-Ⅱ（angiotensin-Ⅱ，AT-Ⅱ）采用放射免疫分析；肾上腺髓质素（adrenomedullin，AM）采用酶联免疫分析。结果：表1可见，患者血清PRL、TSH和GH三项指标水平在术前24h组略高于正常对照组，但无统计学差异（P均〉0．05）；麻醉前组三项指标水平则均显著高于正常对照组（P均〈0．05）；术后24h组三项指标水平更显著高于上述三组（P〈0．05，P〈0．01），且还显著高于麻醉前组（P均〈0．05）。表1中血清cortisol水平在术前24h已显著高于正常对照组（P〈0．05）；AM和AT—Ⅱ含量略高于正常对照组，但无统计学差异（P均〉0．05）；麻醉前组三项指标水平均显著高于正常对照组（P〈0．05，P〈0．01）；术后24h组三项指标水平更显著高于上述三组（P〈0．05，P〈0．01），且还显著高于麻醉前组（P均〈0．05）。结论：本文患者血清六项血清指标的变化证实患者存在明显的应激反应；提醒临床应在手术前后对患者实施必要的药物和心理治疗。

Clinical Significance of Determination the Changes on Related Serum Hormone Levels Both Before and After Chest Operation in Patients with Esophageal Cancer

Objective To explore the changes of related serum hormone levels both before and after chest operation in patients with esophageal cancer and the clinical significance of determination. Methods Serum levels of cortisol, PRL, TSH were determina- tion with chemiluminescence immunoaasay and serum GH and AT- Ⅱ levels with RIA and serum level of AM was determination with ELISA both before and after operation in 30 patients with esophageal cancer as well as in 32 normal control group. Results From ta- ble 1 ： The serun levels of these three hormones in the patients 24h before operation showed slightly higher than those in the normal con- trol group（P 〉0.05） butnoreal statistical difference. Right before anaesthesia,the serun levels all increased more and proved signifi- cantly higher than the normal control group （P 〈 0.05 ）. Post-operatively the serum levels of these three hormones increased further and by 24h, expressed distinctly higher than those in normal control group （P 〈 0.01 ）. From table 2： The serum level of cortisol in the pa- tients 24h before operation indicated significantly higher than that in normal control group （P 〈 0.05 ）, the sermn AM and AT- Ⅱ levels manifested slightly higher but not significantly than the normal control group （P 〉 0.05 ）. Right before anaesthesia, the serun levels all increased more and showed obviously higher than thost in normal control group and 24h before operation group （P 〈 0.05, P 〈 0.01 ）. Post-operatively the serum levels of these three hormones increased further and by 24h, proved apparently higher than before anaesthe- sia group （P 〈 0.05）. Conclusion Stress rcaction were quite evident in these patients undergoing operation with significantly higher serum levels of six hormones. The author of this article to remind the clinician shauld be carried out to patients pro-and post-operation necessary medication and psychotherapy.