Imamura Y, Yokoyama T, Murakami Y, Hiyama E, Takesue Y, Kodama T, Matsuura Y
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Hiroshima J Med Sci. 1995 Jun;44(2):39-46.
The aim of this study was to evaluate the characteristics of the polymorphonuclear leukocyte (PMN) function after surgical stress. We investigated Mac-1 expression and superoxide generation by peripheral PMNs and serum granulocyte-colony stimulating factor (G-CSF) concentrations in 15 patients who underwent either gastrectomy (n = 8) or esophagectomy (n = 7). The serum G-CSF rapidly increased within 24 hours after operation. The maximum levels of serum G-CSF in the cases of esophagectomy were about 5-8 fold those of gastrectomy, although the increases in PMN counts within 24 hours of esophagectomy were lower than those after gastrectomy. Mac-1 expression and superoxide generation by PMN counts and serum G-CSF. After esophagectomy, Mac-1 expression on peripheral PMNs remained elevated through the 7th day after operation, while superoxide generation by PMNs in response to PMA declined to below preoperative levels after the 3rd day. These results suggest that, after major surgery such as esophagectomy, there is a discrepancy between Mac-1 expression and superoxide generation by the peripheral PMN despite a high level of serum G-CSF.
本研究的目的是评估手术应激后多形核白细胞(PMN)功能的特征。我们调查了15例行胃切除术(n = 8)或食管切除术(n = 7)患者外周血PMN的Mac-1表达、超氧化物生成以及血清粒细胞集落刺激因子(G-CSF)浓度。术后24小时内血清G-CSF迅速升高。食管切除术患者血清G-CSF的最高水平约为胃切除术患者的5-8倍,尽管食管切除术后24小时内PMN计数的增加低于胃切除术后。PMN计数和血清G-CSF与Mac-1表达及超氧化物生成有关。食管切除术后,外周血PMN上的Mac-1表达在术后第7天仍保持升高,而PMN对佛波酯(PMA)反应产生的超氧化物在术后第3天降至术前水平以下。这些结果表明,在食管切除术等大手术后,尽管血清G-CSF水平较高,但外周血PMN的Mac-1表达与超氧化物生成之间存在差异。