[腹部手术后瘦素血浆水平的动态变化]

[Dynamics of leptin plasma levels after abdominal surgical procedures].

作者信息

Maruna P, Gürlich R, Frasko R

机构信息

Ustav patologické fyziologie, 1. LF UK, Praha.

出版信息

Rozhl Chir. 2001 Jun;80(6):299-303.

PMID:11482152

Abstract

UNLABELLED

In addition to its basic role as regulator of the amount of body fat and food intake leptin plays a part also as an acute phase reactant. A rise of the leptin level during this period may be associated with anorexia and cachexia in relation to general inflammatory manifestations. The objective of the present study was to characterize the dynamics of the leptin concentration in patients after intraabdominal surgery.

PATIENTS AND METHODS

The prospective study was implemented in a group of 16 men subjected to planned surgery--resection of colorectal carcinoma. The plasma leptin concentration (RIA), TNF alpha, IL-beta. IL-6, sIL-2R (ELISA), CRP, alpha-1-antitrypsin, alpha-1-acid glycoprotein and ceruloplasmin (nephelometry) were assessed before surgery and then +24, +48 and +72 hours after the beginning of the operation and compared with concentrations in healthy subjects.

RESULTS

Plasma leptin concentrations culminate +24 hours after surgery and in this stage they do not correlate with the BMI. Within 48 hours the concentration reaches rapidly normal levels. TNF alpha, IL-6 and sIL-2R reach maximal levels 24-48 hours after the onset of surgery with a subsequent slow decline. All acute phase proteins (APP) have prolonged dynamics with an elevation within +72 hours. A significant correlation was proved between the leptin concentration and TNF alpha 24 hours after surgery (r = 0.43, p < 0.05) and between leptin and IL-6 24 hours after surgery (r = 0.32, p < 0.05).

CONCLUSION

The dynamics of the plasma leptin concentration during the postoperative period differ from the typical development of early indicators of the systemic inflammatory response--cytokines as well as from the dynamics of APP. Leptin elevation during this period may contribute to anorexia of patients after major surgery. However, rapid normalization of the level within 48 hours after surgery indicates however that leptin is involved also in other, so far unspecified factors with an anorectic action.

摘要

未标注

除了作为身体脂肪量和食物摄入量的调节因子这一基本作用外，瘦素还作为一种急性期反应物发挥作用。在此期间瘦素水平的升高可能与厌食和恶病质以及全身炎症表现有关。本研究的目的是描述腹部手术后患者瘦素浓度的动态变化。

患者和方法

前瞻性研究在一组16名接受计划性手术——结肠直肠癌切除术的男性患者中进行。在手术前以及手术开始后24小时、48小时和72小时评估血浆瘦素浓度（放射免疫分析法）、肿瘤坏死因子α、白细胞介素β、白细胞介素6、可溶性白细胞介素2受体（酶联免疫吸附测定法）、C反应蛋白、α1抗胰蛋白酶、α1酸性糖蛋白和铜蓝蛋白（散射比浊法），并与健康受试者的浓度进行比较。

结果

血浆瘦素浓度在术后24小时达到峰值，在此阶段它们与体重指数无关。48小时内浓度迅速恢复到正常水平。肿瘤坏死因子α、白细胞介素6和可溶性白细胞介素2受体在手术开始后24 - 48小时达到最高水平，随后缓慢下降。所有急性期蛋白（APP）的动态变化持续时间较长，在72小时内升高。术后24小时瘦素浓度与肿瘤坏死因子α之间存在显著相关性（r = 0.43，p < 0.05），术后24小时瘦素与白细胞介素6之间也存在显著相关性（r = 0.32，p < 0.05）。