Department of Surgery, Maastricht University Medical Center & Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, the Netherlands.
HPB (Oxford). 2011 May;13(5):324-31. doi: 10.1111/j.1477-2574.2010.00289.x. Epub 2011 Mar 7.
Plasma interleukin-6 (IL-6) levels increase during liver resection. The source of this IL-6 is hitherto unclear. It has been demonstrated that the hepatosplanchnic area takes up IL-6 but the role of the gut and liver is unknown. The aim of the present study was to investigate the role of the gut and liver in IL-6 homeostasis during liver surgery.
Before and after partial hepatectomy, IL-6 was measured in blood sampled from the radial artery, and the hepatic and portal vein. Blood flow was measured to assess IL-6 fluxes (flow times AV-differences) across the gut, liver and hepatosplanchnic area.
In 22 patients undergoing liver resection, IL-6 release from the gut after transection was 90.9 (30.1) ng/min (P < 0.001), whereas net IL-6 uptake by the liver equalled 83.4 (41.7) ng/min (P < 0.01). Overall hepatosplanchnic flux was 7.3 (43.5) ng/min after transection and did not differ significantly from zero. Overall hepatosplanchnic flux was 87.8 (41.5) ng/min in the major resection group and -59.8 (67.5) ng/min in the minor resection group (P < 0.05).
The gut releases IL-6 and the liver takes up IL-6 before and after liver resection. The loss of IL-6 uptake as a result of a small functional remnant liver could lead to higher IL-6 levels after surgery.
肝切除术中血浆白细胞介素 6（IL-6）水平升高。目前尚不清楚这种 IL-6 的来源。已经证明，肝肠区域摄取 IL-6，但肠道和肝脏的作用尚不清楚。本研究旨在探讨肠道和肝脏在肝手术期间 IL-6 动态平衡中的作用。
在部分肝切除术前和术后，从桡动脉、肝静脉和门静脉采集血液，测量 IL-6。测量血流量以评估肠道、肝脏和肝肠区域的 IL-6 通量（流量乘以 AV 差异）。
在 22 例接受肝切除术的患者中，横断后肠道释放的 IL-6 为 90.9（30.1）ng/min（P <0.001），而肝脏对 IL-6 的净摄取量等于 83.4（41.7）ng/min（P <0.01）。横断后总体肝肠通量为 7.3（43.5）ng/min，与零无显著差异。在大切除组总体肝肠通量为 87.8（41.5）ng/min，在小切除组为-59.8（67.5）ng/min（P <0.05）。
肠道释放 IL-6，肝脏在肝切除术前和术后摄取 IL-6。由于功能性残余肝体积小而导致 IL-6 摄取丧失，可能导致术后 IL-6 水平升高。
