Rem J, Nielsen O S, Brandt M R, Kehlet H
Acta Chir Scand Suppl. 1980;502:51-6.
Postoperative changes in various acute phase proteins (transferrin, albumin, prealbumin, orosomucoid, haptoglobin, IgA, IgG, and IgM), plasma glucose, and cortisol were studied in twelve otherwise healthy premenopausal women undergoing elective hysterectomy during either general anaesthesia or epidural analgesia (T4-S5). The results showed a 10-20% decrease of all proteins during the first postoperative day (p less than 0.05), followed by a gradual, significant increase of orosomucoid to 80% and of haptoglobin to 140% above preoperative levels on day seven after surgery in both groups. The other proteins remained significantly decreased during the second postoperative day, but returned to preoperative levels by day seven after surgery in both groups. Epidural analgesia blocked the normal postoperative increase in plasma glucose and cortisol. Plasma levels of transferrin, albumin, prealbumin, IgA, IgG, and IgM were significantly lower during the first postoperative day in the epidural group. It is concluded that postoperative changes in acute phase proteins are mediated by factors other than neurogenic stimuli and adrenal hormones.
对12名健康的绝经前女性进行了研究，这些女性在全身麻醉或硬膜外镇痛（T4-S5）下接受择期子宫切除术，观察术后各种急性期蛋白（转铁蛋白、白蛋白、前白蛋白、类粘蛋白、触珠蛋白、IgA、IgG和IgM）、血糖和皮质醇的变化。结果显示，术后第一天所有蛋白均下降10%-20%（p<0.05），随后两组术后第七天类粘蛋白逐渐显著增加至术前水平的80%，触珠蛋白增加至术前水平的140%。其他蛋白在术后第二天仍显著下降，但两组术后第七天均恢复至术前水平。硬膜外镇痛可阻断术后血糖和皮质醇的正常升高。硬膜外组术后第一天转铁蛋白、白蛋白、前白蛋白、IgA、IgG和IgM的血浆水平显著较低。结论是，急性期蛋白的术后变化是由神经源性刺激和肾上腺激素以外的因素介导的。
