恶性肿瘤引起的梗阻性黄疸患者手术前后细胞因子变化的意义

目的:探讨恶性肿瘤引起的梗阻性黄疸患者手术前后细胞因子的变化,揭示引起黄疸的炎症反应机制及其临床意义。方法:用酶联免疫吸附测定(ELISA)检测实验组(11例,由恶性肿瘤引起的梗阻性黄疸患者)、良性对照组(10例,由结石引起的梗阻性黄疸患者)及恶性对照组(6例,胆道恶性肿瘤未合并梗阻性黄疸患者)术前、术后血清白细胞介素Ⅳ(IL-6)及白细胞介素Ⅹ(IL-10)的水平。结果:实验组术前血清IL-6、IL-10水平明显高于术后,差异有显著性(P<0.05)。实验组及良性对照组血清IL-6、IL-10水平均高于恶性对照组,差异有显著性(P<0.05)。所有梗阻性黄疸患者血清中,IL-10水平与IL-6水平、体温、白细胞计数有关联,而与血清总胆红素无关联。结论:解除黄疸有助于患者机体免疫功能的恢复及中止机体抗炎反应,检测血清中细胞因子有助于判断疾病的转归情况。

The changes of cellular factor in perioperative patients with obstructive jaundice caused by biliary malignancy

Objective: To study the changes of cellular factor in perioperative patients with obstructive jaundice caused by biliary malignancy,and to detennine the mechanism and clinical significance. Methods:The subjects were 11 cases of obstructive jaundice caused by biliary malignancy. The controls, 10 cases of obstructive jaundice were caused by choledo-cholithiasis and 6 cases had biliary malignancy without obstructive jaundice. The level of IL-6, IL-10 in 27 cases before and after operation were tested by ELISA method. Results: After biliary drainage, the concentrations of IL-6 and IL-10 were significantly reduced in the subjects(P <0.05). The levels of IL-6 and IL-10 were significantly higher in the subjects and the chololithic obstruction controls than in the cancer controls. In the subjects and the chololithic obstruction controls, the plasma concentrations of IL-10 were significantly correlated with the IL-6 concentrations, body temperature and the white blood cell count( P < 0.05) . Serum total bilirubin levels did not correlated with plasma IL-10 concentration. Conclusion:The result suggests that relief of jaundice can improve the immunlogic function of the patient.