血清IL-2/SIL-2R系统平衡紊乱在梗阻性黄疸围手术期中作用的临床研究

目的 探讨梗阻性黄疸（梗黄）病人围手术期血清白细胞介素-2（IL-2）活性和可溶性白细胞介素-2受体（SIL-2R）表达状况及IL-2／SIL-2R系统平衡紊乱的临床意义。方法39例梗黄病人（良性21例，恶性18例），分别采用放免计数器和双抗体夹心ELISA法测定血清IL-2和SIL2R水平。结果（1）良恶性两组术前血清IL-2较对照组明显降低，SIL-2R明显高于对照组，术后逐渐恢复，但良恶性两组变化幅度差异明显；（2）血清总胆红素与血清IL-2及SIL-2R水平之间密切相关；（3）胆道外引流术式较内引流术式相对不利于梗黄病人术后血清IL-2和SIL-2R水平的恢复。结论梗黄病人体内存在血清IL-2／SIL-2R系统平衡紊乱，监测血清IL-2和SIL-ZR有助于估价病情、判断预后及鉴别梗阻的性质，胆道外引流相对不利于血清IL-2和SIL-2R的恢复。

Role of serum interleukin-2/soluble interleukin-2 receptor imbalance in patients with obstructive jaundice

Objective To investigate the changes in serum interleukin-2(IL-2)and soluble in- terleukin-2 receptor(SIL-2R)levels and explore the clinical significance of IL-2/SIL-2R imbalance in patients with obstructive jaundice(OC).Methods The 39 patients with OC were divided into the be- nign group and malignant group.Serum IL-2 and SIL-2R levels were dynamically determined in both groups by radioimmunoassay and ELISA.Results Preoperative serum level of IL-2 in the 2 groups was significantly lower but that of SIL-2R higher than those in the normal control group.The postop- erative serum levels of IL-2 and SIL-2R gradually resumed in the 2 groups of patients.There was sig- nificant difference in the levels between the benign group and malignant group.Rank correlation analy- sis showed a relationship between the serum level of bilirubin and serum levels of IL-2 and SIL-2R.On day 7 and 12 following operation,serum IL-2 and SIL-2R levels in the benign patients treated by ex- ternal biliary drainage did not resumed as compared with those by internal biliary drainage.Conclusions There is imbalance of serum IL 2/SIL-2R in patients with OC.Determination of serum IL-2 and SIL-2R levels might be a valuable method for estimating the patients'conditions,assessing the pa- tients'prognosis and identifying the nature of OC.The recovery of serum IL-2 and SIL-2R levels by external biliary drainage is relatively slow.