全髋关节置换术后血清炎性因子表达特点及临床意义

目的：研究血清炎性因子白介素1（IL1）、白介素2（IL2）、白介素6（IL6）及白介素10（IL10）在人工全髋关节置换术后变化特点及意义。方法：自2010年2月至6月,选择初次行单侧人工全髋关节置换术的30例股骨头无菌性坏死患者,男18例,女12例;年龄52～70岁,平均（58.4±6.6）岁;FicatⅡ型20例,Ⅲ型10例。分别在术前第1天及术后第1、3天用放射免疫方法检测IL1、IL2、IL6及IL10,同时检测C反应蛋白,对结果进行统计学分析。结果：人工全髋关节置换术后第1天患者血清中IL1、IL6和IL10值均较术前升高（t=2.62,3.51,2.21,P〈0.05）,在术后1～3d达到高峰,3d后开始降低。患者血清IL2水平术后降低（t=2.16,P〈0.05）,后逐渐升高。结论：全髋关节置换术后3d是抗炎治疗的关键,术后及时监测IL1、IL2、IL6及IL10的变化,同时观察临床症状,可更敏感地掌握患者的治疗效果,预测病情发展。

Clinical significance and expression of the inflammatory cytokines(IL-1,IL-2,IL-6 and IL-10) in blood serum of the patients after total hip replacement

Objective：To evaluate the changes in the expressions of the inflammatory cytokines （IL-1,IL-2,IL-6 and IL-10） in blood serum of the patients after total hip replacement（THR）.Methods：From February 2010 to June 2010,thirty patients undergone primary total hip arthroplasty in one side including 18 male and 12 female with the mean age of（58.4±6.6） years （ranged from 52 to 70 years）.Twenty patients were Ficat Ⅱ type,and 10 patients were Ficat Ⅲ type.The contents of IL-1,IL-2,IL-6 and IL-10 in blood serum were detected on the day before operation and 1,3 days after operation respectively by ELISA.At the same time,the content of C reactive protein was also detected,and the results were statistically analyzed.Results：The contents of IL-1,IL-6 and IL-10 in the serum of patients at the first day after THR were significantly higher than those before operation（t=2.62,3.51,2.21,P0.05）,and reached the peak at 1 to 3 days after operations,then subsequently decreased.However,the content of IL-2 in the serum of patients after operation was obvious lower （t=2.16,P0.05）,and recovered to normal level gradually.Conclusion：It is the key time of treatment at 1 to 3 days after THR.Monitoring IL-1,IL-2,IL-6 and IL-10 after operation in time,and monitoring life sign at the same time could sensitively observe the effect of treatment and forecast the trend of diseases in patients.