腹腔镜复杂肝脏切除术围术期 GP73 和红细胞 CD35、CD58、CD44s 分子及肝肾功能的变化

目的观察腹腔镜复杂肝脏切除术围术期患者高尔基体蛋白（GP）73和红细胞CD35、CD58、标准型CD44（CD44s）分子及肝肾功能的变化规律，探讨腹腔镜复杂肝脏切除术的临床应用价值。方法选取2009年1月至2012年6月采用腹腔镜复杂肝脏切除术治疗的20例患者为观察组，同期进行开腹复杂肝脏切除术治疗的20例患者为对照组，对两组患者术前及术后3、7d的GP73、CD35、CD58、CD44s分子及肝肾功能指标进行定量检测和比较。结果术后3d、7d观察组GP73的水平低于对照组（P均〈0．05）；红细胞CD35和CD58、CD44s分子数量均高于对照组（P均〈0．05）；肝肾功能指标波动幅度也均小于对照组（P均〈0．05）。结论与开腹复杂肝脏切除术比较，腹腔镜复杂肝脏切除术对患者的肿瘤标志物GP73水平的降低更明显，对红细胞CD35和58分子、CD44s水平及肝肾功能的不良影响较小，且恢复速度更快。

The changes of GP73, red cell CD35, CD58, CD44s and liver and kidney functions in perioperative period of laparoscopic complex liver resection

Objective To observe the changes of Golgi protein 73 （GP73）, red cell CD35, CD58 ,standard CD44 （CD44s） and liver and kidney functions in perioperative period of laparoscopic complex liver resection and explore the value of clinical application of laparoscopic complex liver resection. Methods Twenty patients received laparoscopic complex liver resection from January 2009 to June 2012 were selected as observation group, and 20 patients received open complex liver resection at the same time were selected as control group. GP73, red cell CD35, CD58, CD44s levels and liver and kidney function indexes at the third day and the seventh day after the operation were quantitatively detected and compared. Results The levels of GP73 at 3rd and 7th day after operation in observation group were lower than those in control group （ all P 〈 0.05）. The molecule numbers of red cell CD35, CD58, CD44s in observation group were all higher than those in control group （ all P 〈 0.05 ）. The variation amplitude of liver and kidney function indexes in observation group were all lower than those in control group （ all P 〈 0.05 ）. Conclusions Compared with open complex liver resection, the laparoscopic complex liver resection can decrease the tumor marker-GP73 level, reduce the operative harmful effect on red cell CD35, CD58 and CD44s levels,and liver and kidney functions , also accelerate their recovery speed.