Kimura F, Miyazaki M, Suwa T, Itoh H, Ambiru S, Shimizu H, Nakagawa K
Department of Surgery, Omiya Red Cross Hospital, Yono, Japan.
Eur Surg Res. 1998;30(4):259-67. doi: 10.1159/000008585.
The relation of interleukin-6 (IL-6) levels in serum to the postoperative complications was assessed in 50 patients following an extensive hepatectomy. In addition, the postoperative levels of IL-6, tumor necrosis factor-a, and interleukin-1beta in peritoneal exudative fluid were determined in 22 patients. The patients with preoperative biliary obstruction showed a higher incidence of postoperative infection compared to those without (44 vs. 12%, p = 0.043). The postoperative serum IL-6 levels on day 1 were significantly higher in patients with postoperative infection than in those without (p<0.01). Biliary obstruction and intraoperative blood loss contributed to the increase in the serum IL-6 levels in a multiple regression analysis (p = 0.01 and p = 0.044, respectively). Further, the fluid levels of inflammatory cytokines were significantly higher in patients with biliary obstruction than in those without (p<0.05). These results suggest that in patients with biliary obstructions a hyperactive cytokine response occurs after an extensive hepatectomy and results in a high incidence of postoperative infection.
对50例接受广泛肝切除术后的患者评估血清白细胞介素-6（IL-6）水平与术后并发症的关系。此外，测定了22例患者腹腔渗出液中IL-6、肿瘤坏死因子-α和白细胞介素-1β的术后水平。术前有胆道梗阻的患者术后感染发生率高于无胆道梗阻的患者（44%对12%，p = 0.043）。术后感染患者术后第1天的血清IL-6水平显著高于未感染患者（p<0.01）。在多元回归分析中，胆道梗阻和术中失血导致血清IL-6水平升高（分别为p = 0.01和p = 0.044）。此外，有胆道梗阻患者的炎症细胞因子的液体水平显著高于无胆道梗阻患者（p<0.05）。这些结果表明，在有胆道梗阻的患者中，广泛肝切除术后会发生细胞因子反应亢进，并导致术后感染的高发生率。
