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目的 探讨婴幼儿重大手术后血浆中白细胞介素 6 (IL 6 )水平对外周血中性粒细胞(PMN)凋亡的影响以及两者在手术应激时对机体的影响。方法 ①选取 35例择期手术患儿 (1～ 3岁 ,平均 2 .8岁 ) ,参照手术应激评分标准[1] 分为大手术组和小手术组 ,检测患儿术前与术后血浆中IL 6水平及外周血中性粒细胞计数 ;②采用 percoll非连续梯度密度沉降法获人外周血PMN ,置于不同浓度的人重组白细胞介素 6 (rhIL 6 )的RPMI 16 40培养基中培养 2 4h ,用流式细胞术 (FCM)进行DNA凋亡分析。结果 ①发现术后血浆中IL 6水平大手术组 (12 1.0± 2 7.3) pg/ml明显高于小手术组 (33.5± 15 .9) pg/ml,且外周血中PMN大幅上升 ;②在体外实验中 ,随着IL 6浓度的升高 ,PMN的凋亡率逐渐下降。结论 IL 6通过延迟PMN的凋亡 ,参与机体手术应激后的“升白”过程 ,从而影响机体创伤后由PMN介导的高炎症反应所致的组织损伤
Objective To investigate the effect of interleukin - 6 (IL - 6) on the apoptosis of peripheral blood neutrophils (PMN) in infants and young children after major surgery and their effects on the body during surgical stress. Methods ① Thirty-five children undergoing elective surgery (1-3 years old, mean age 2.8 years) were enrolled in this study. According to the surgical stress score [1], the patients were divided into major surgery group and minor surgery group. Preoperative and postoperative plasma IL 6 levels and peripheral blood neutrophil count; ② Percoll non-continuous gradient density sedimentation method to obtain peripheral PMN, placed in different concentrations of human recombinant interleukin 6 (rhIL 6) RPMI 16 40 medium After culturing for 24 h, DNA apoptosis was analyzed by flow cytometry (FCM). Results ① The postoperative plasma levels of IL-6 in the major surgery group (12 1.0 ± 2. 7.3 pg / ml) were significantly higher than those in the minor surgery group (33.5 ± 15.9 pg / ml) In vitro experiments, with the IL 6 concentration, PMN apoptosis rate decreased gradually. Conclusion IL 6 can delay the PMN apoptosis and participate in the process of “lightening” after surgical stress, which may affect the tissue damage caused by PMN-mediated high-inflammatory reaction after trauma