腹腔镜和开腹胆囊切除术对患者血清细胞因子IL-6、IL-10和IL-18的影响

目的:探讨腹腔镜胆囊切除术(LC)和开腹胆囊切除术(OC)对慢性结石性胆囊炎患者血清IL-6、IL-10和IL-18影响,比较两种方法对机体肝功能的损伤和机制。方法:选择LC患者和OC患者各30例,分别于术前、术后1d、5d抽取静脉血测定血清ALT、AST、IL-6、IL-10和IL-18含量,并进行对比研究。结果:LC组和OC组术后血清ALT、AST、IL-6和IL-18含量均较术前增加(P<0.01),血清IL-10含量较术前降低(P<0.01),上述指标术后1d变化最为明显,LC组上述血清指标变化小于同期OC组(P<0.05)。结论:LC对患者肝功能损伤较OC小,可能与LC刺激机体产生IL-6和IL-18较少,维持较高血清IL-10水平,维护适度机体细胞因子平衡有关。

Effect of laparoscopic cholecystectomy on the changes of cytokine IL-6,IL-10 and IL-18 in patients

Objective:To investigate the influence of laparoscopic cholecystectomy(LC)and open cholecystectomy(OC)on the inflammatory cytokine IL-6,IL-10 and IL-18 in patients suffering chronic.Methods:Each group had thirty patients.The blood was collected on 1d,5d before and after operation.The hepatic function was detected by biochemistry.Serum level of IL-6,IL-10 and IL-18 was determined by ELISA.Results:Serum IL-6,IL-18,ALT and AST increased,reaching their peaks on 1d after operation in LC and OC groups and decreased on 5d after operations(P<0.01).Serum levels of ALT,AST IL-6 and IL-18 in LC group were higher than those in OC group(P<0.01).Serum IL-10 concentration was significantly decreased in two groups after operation(P<0.01).Conclusions:LC causes smaller alteration in serological hepatic parameters than OC,LC maintains a moderate inflammatory response and an adequate balance of cytokine in patients with chroric cholecystitis