小儿急性阑尾炎手术前后sICAM-1、IL-8和TNFa的变化及其临床意义

目的探讨急性阑尾炎患儿血清可溶性细胞间粘附分子-1（sICAM-1）、白细胞介素-8（IL-8）和肿瘤坏死因子-a（TNFa）的变化及临床意义。方法应用酶联免疫吸附测定法检测70例急性阑尾炎患儿不同时间（术前、术后7d）血清中sICAM-1、IL-8和TNFa的含量水平。结果各组术前血清sICAM-1、IL-8、TNFa的水平明显高于对照组（P〈0．01）；化脓性、坏疽穿孔性阑尾炎组血清sICAM-1与IL-8、TNFa变化呈正相关（P〈0．05）；单纯组外周血白细胞（WBC）与sICAM-1呈正相关（P〈0．05）；8例并发症血清sICAM-1与IL-8、TNFa升高明显。结论血清sICAM-1、IL-8和TNFa在小儿急性阑尾炎的发病中起着重要的作用，检测其变化对小儿急性阑尾炎的诊断、病程监测和预后估计具有一定的临床价值。

Serum sICAM-1, IL-8 and TNFα in children with acute appendicitis

Objective To explore the clinical significance of serum sICAM-1, IL-8, TNFa in children with acute appendicitis before and after operation. Methods The levels of serum sICAM-1, IL-8, TNFa were detected by ELISA in 70 children with the acute appendicitis before and after operation. Same indexes were also measured in control group. Results The levels of serum sICAM-1, IL-8 and TNFa in the children with acute appendicitis were significantly higher than those in control group. There was a positive correlation between the sICAM-1 and IL-8 or TNFa in the acute phlegmonous and gangrenous appendicitis. The serum level of sICAM-1 in children with catarrhal appendicitis was closely related with the count of white blood cells. Moreover, higher serum sICAM-1, IL-8 and TNFa was noted in 8 cases with postoperative complications. Conclusions Detection of serum sICAM-1, IL- 8 and TNFa may be useful for diagnosis and surveillance of the appendicitis in children.