单侧与双侧全膝关节置换术后患者血清白细胞介素-6浓度

Serum concentrations of interleukin-6 in patients following unilateral versus bilateral total knee arthroplasty.

作者信息

Kugisaki Hajime, Sonohata Motoki, Komine Mitsunori, Tsunoda Kenji, Someya Shinsuke, Honke Hidefumi, Mawatari Masaaki, Hotokebuchi Takao

机构信息

Department of Orthopedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan.

出版信息

J Orthop Sci. 2009 Jul;14(4):437-42. doi: 10.1007/s00776-009-1344-9. Epub 2009 Aug 7.

DOI:10.1007/s00776-009-1344-9

PMID:19662479

Abstract

BACKGROUND

Surgical stress is known to affect body temperature, white blood cell (WBC) count, C-reactive protein (CRP), and interleukin-6 (IL-6). The aim of the present study was to investigate which parameter is most suitable for quantitative analysis of surgical stress.

METHODS

Unilateral total knee arthroplasty (U-TKA) and bilateral TKA (B-TKA) were selected for the subjects of this study because the B-TKA creates approximately double the surgical stress of the U-TKA. The temperature, WBC count, CRP, and IL-6 in the blood were measured pre- and postoperatively in both groups. The IL-6 in the drainage fluid was also measured after the operation.

RESULTS

The temperature, WBC count, CRP, and IL-6 in the blood significantly increased on the first day after the operation in both groups. There were significant differences between the two groups in the WBC count (P < 0.05) and the IL-6 level in the blood (P < 0.05) on the first day after the surgery. There were no significant differences between the two groups for the CRP and IL-6 levels in the drainage fluid. The relative proportions--(B-TKA/U-TKA) x 100 (%)--were 170.4% for the operating time, 219.4 % for total blood loss, 200.0% for blood transfusion, 100.3% for temperature, 128.9% for WBC count, 127.4% for CRP, and 246.5% for the IL-6 level in the blood.

CONCLUSIONS

The serum IL-6 level may best reflect surgical stress and could therefore be a quantitative marker of surgical stress.

摘要

背景

已知手术应激会影响体温、白细胞（WBC）计数、C反应蛋白（CRP）和白细胞介素-6（IL-6）。本研究的目的是调查哪个参数最适合用于手术应激的定量分析。

方法

本研究选择单侧全膝关节置换术（U-TKA）和双侧全膝关节置换术（B-TKA）作为研究对象，因为B-TKA产生的手术应激约为U-TKA的两倍。两组患者均在术前和术后测量血液中的温度、WBC计数、CRP和IL-6。术后还测量了引流液中的IL-6。

结果

两组患者术后第一天血液中的温度、WBC计数、CRP和IL-6均显著升高。术后第一天两组患者的WBC计数（P < 0.05）和血液中的IL-6水平（P < 0.05）存在显著差异。两组患者引流液中的CRP和IL-6水平无显著差异。相对比例——（B-TKA/U-TKA）×100（%）——手术时间为170.4%，总失血量为219.4%，输血量为200.0%，体温为100.3%，WBC计数为128.9%，CRP为127.4%，血液中的IL-6水平为246.5%。