子宫切除患者手术前后炎性细胞因子的变化及乌司他丁的调节作用

目的：探讨乌司他丁对子宫切除术患者炎性细胞因子的调节作用。方法：125例子宫肌瘤需行子宫切除的手术患者随机分为治疗组和对照组,治疗组62例,对照组63例。所有患者均在气插全麻下行子宫切除术。治疗组在术前30min开始给予乌司他丁3000U/kg·次,加入5%葡萄糖水100ml中静脉滴注,1次/8h,共6次;对照组则给予等量、等次数的5%葡萄糖水。结果：术前两组患者IL-6、IL-8、TNF-α含量基本相当（P〉0.05）。术后,两组患者IL-6、IL-8、TNF-α含量均较术前明显升高（均P〈0.05）,但是治疗组IL-6、IL-8、TNF-α含量升高幅度较对照组明显要低（均P〈0.05）;术后IL-6、IL-8、TNF-α含量的下降速度,治疗组明显要快于对照组（均P〈0.05）。结论：乌司他丁对子宫切除手术创伤引起炎性细胞因子IL-6、IL-8、TNF-α的分泌与释放有一定的抑制作用,有助于患者重要脏器功能的保护。

Regulation of Changes of Inflammatory Cytokines Expressions After Operation with Ulinastatin in Patients with Hysterectomy

Objective To study the effect of ulinastatin on changes of expressions of inflammatory cytokines after operation in patients with hysterectomy.Methods Among 125 patients undergone hysterectomy under intratracheal general anesthesia,ulinastatin 3000U/kg in 100ml of 5% glucose water were given i.v.30min before operation to 62 patients and thereafter q8h for 5times.The equivalent amount of 5% glucose water was given to the other 63 patients as controls,Serum IL-6,IL-8 and TNF-α levels were determined with ELISA 1h before operation and 24,48,72h after operation repeatedly in all these patients.Results Before operation,the levels of IL-6,IL-8,and TNF-α were about the same （P 〈0.05） in the two groups.Twenty four hours after operation,the levels of IL-6,IL-8 and TNF-α in both groups were significantly higher than those before operation （all P 〈0.05） ,but the increases in ulinastatin treated group were significantly less than those in controls （all P 〈0.05） ,while at 72h after operation the levels of IL-6,IL-8,and TNF-α in treated group dropped much quicker and were significantly lower than those in controls （all P 〈0.05） .Conclusion Ulinastatin might be able to inhibit the secretion and release of inflammatory cytokines IL-6,IL-8,and TNF-α induced by surgical trauma after hysterectomy,which would be protective to the patients.