开胸手术患者围术期il-6 il-8的动态变化及意义-dynamic changes and significance of il - 6 il - 8 in perioperative period of patients undergoing thoracotomy.docxVIP

开胸手术患者围术期 IL-6、IL-8 的动态变化及意义中文摘要目的：了解开胸手术围术期机体 IL-6、IL-8 的动态变化，初步探究其变化规律及临 床意义，为临床医生在手术治疗、快速康复等方面提供一定理论依据。方法：监测患者开胸手术血浆中 IL-6、IL-8 浓度的动态变化。采用酶联免疫吸附法 检测开胸手术患者在围手术期不同时间点(术前 24h,术中 1h、2h、3h，术后 8h、16h、 24h、32h,40h、48h、56h、64h、72h、120h、168h（清晨 6：00-8：00 时安静状态下）) 血浆中 IL-6、IL-8 的水平，以健康成人血浆中 IL-6、IL-8 的水平作为对照。用 SPSS19.0 进行数据分析。结果：1.研究组术前 IL-6、IL-8 浓度与健康组相比无统计学差异(P0.05)。2.手术开始 1h 后，研究组血浆中 IL-6、IL-8 浓度皆成上升趋势，差异有统计学意义 (P0.05)。研究组 IL-6、IL-8 浓度浓度自 24h 达到顶峰，分别为 149.79±5.98ng/l、 134.81±4.91ng/l，其后开始下降，72h 下降至 118.48±6.90ng/l、105.802±9.89ng/l，IL-6、 IL-8 在术后 168h 降至正常水平。部分病人的 IL-6、IL-8 浓度存在双高峰。3.研究组 IL-8 与 IL-6 之间呈正相关，其中 r=0.97，P0.05。4.IL-8 随 IL-6 的增加而增加，二者之间存在明显线性关系，P0.05；IL-8 与 IL-6 的 线性回归方程为：y=17.83+0.976x。研究组 IL-8 和 IL-6 高度相关。结论：（1）可通过回归方程 IL-8 值=17.83+0.976*IL-6 值，以白细胞介素-6 的值计算白细胞 介素-8 的值；（2）开胸手术后 24h 可能是预防术后并发症的关键时期；（3）开胸手术后 24h 后持续上升或下降后又反转上升（呈双峰），则应考虑有并发 症出现的可能。关键词：开胸手术，围术期，白细胞介素-6，白细胞介素-8Peri-operative dynamic changes and significance of IL-6, IL-8 in patients with thoracic operationAbstractObjective: To investigate the clinical significance of plasma levels of proinflammatory cytokines interleukin-6(IL-6) and interleukin-8 (IL-8) in patients undergoing thoracic surgery.Methods: Plasma concentrations of IL-6 and IL-8 were measured in 28 patients during perioperative period. Blood samples were taken on the preoperative 24h, and 1h, 2h, 3hduring the operation, 8h、16h、24h、32h, 40h、48h、56h、64h、72h、120h、168h aftersurgery. Plasma IL-6 and IL-8 were measured by ELISA test(enzyme linked immuno-sorbent assay). The SPSS 19 software package was used for data analysis.Results:There was no significant difference (P 0.05) in the levels of IL-6 and IL-8 between the experimental group before surgery concentrations and the healthy group.The concentration of IL-6 and IL-8 showed a rising trend from the 1st h after operation to the postoperative day 5 in the experimental group,and there was a significant statistical difference(P0.05). The IL-6 and IL-8 reached the peak at postoperative 24h(14