儿童手术应激后外周血中B7-H3水平变化及临床意义

发布时间：2018-01-13 18:29

  本文关键词：儿童手术应激后外周血中B7-H3水平变化及临床意义　出处：《苏州大学》2015年硕士论文　论文类型：学位论文

  更多相关文章： B7-H3 手术应激 小儿

【摘要】：目的:手术应激可以导致机体免疫功能受损,使得机体对病原微生物的易感性增加,术后并发症和死亡率相应升高。B7-H3作为共刺激分子中的一员,在免疫调节中发挥着一定的作用。本课题通过对不同程度手术应激患儿外周血中B7-H3水平的检测,探讨其相关的临床意义。方法:选择择期手术患儿48例,其中普外手术组20例,心脏手术组28例。同时根据Anand和Aynsley-Green评分系统评定手术应激程度,分为中度应激组(n=14)和重度应激组(n=34),分别于术前、术后即刻、术后1天、术后3天和术后7天采集外周血,检测患儿血中B7-H3水平。此外,我们还对不同时间点B7-H3水平与患儿的Anand和Aynsley-Green评分及术后并发症进行了相关性分析。结果:所有患儿术后B7-H3水平比术前明显降低(p0.01)。普外手术组患儿,术后不同时间点B7-H3水平与术前相比均有明显下降(术后即刻和术后3天的p0.01,术后1天和术后7天的p0.05)。心脏手术组患儿,术后即刻与术后3天的B7-H3水平相比于术前有明显的下降(p0.05)。心脏手术组患儿在术后1天(p0.05)和术后3天(p0.01)时B7-H3的表达水平相比于普外手术组有明显的下降。重度应激组患儿在术后1天、术后3天和术后7天时B7-H3的表达水平相比于中度应激组患儿有明显的下降(p0.05)。此外,在术后1天(p=0.010)和3天(p=0.025)的B7-H3水平与患儿的Anand和Aynsley-Green评分存在负相关性。结论:B7-H3水平在普外手术和心脏手术患儿中出现明显下降,其与手术应激程度紧密相关。术后1天和术后3天B7-H3的水平与患儿的Anand和Aynsley-Green评分呈负相关提示B7-H3可能作为手术应激程度强弱标志物而应用于临床。
[Abstract]:Objective: surgical stress can lead to impaired immune function, increase the body's susceptibility to pathogenic microorganism, postoperative complications and mortality increased.B7-H3 as a member of costimulatory molecules, play a role in immune regulation. This study through the detection of different degree of surgical stress in peripheral blood in children with B7-H3 levels and explore its clinical significance. Methods: 48 cases of patients undergoing elective surgery, general surgery group 20 cases, group 28 cases of open heart surgery. At the same time according to the Anand and Aynsley-Green scoring system to evaluate the surgical stress degree, divided into moderate stress group (n=14) and severe stress group (n=34), respectively before operation. Immediately after the operation, 1 days after the operation, after 3 days and 7 days after operation to collect peripheral blood, detect the level of B7-H3 in the blood. In addition, we have Anand and Aynsley-Green score and operation at different time points after B7-H3 level and children 骞跺彂鐥囪繘琛屼簡鐩稿叧鎬у垎鏋，

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