小儿肾母细胞瘤手术前后血清促肾上腺皮质激素 皮质醇 心钠素及白细胞介素-6水平变化及临床意义

doi:10.3969/j.issn.1006-6233.2021.05.016

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摘要 目的: 探讨小儿肾母细胞瘤手术前后血清促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、皮质醇(cortisol,Cor)、心钠素(atrial natriuretic peptide,ANP)及白细胞介素-6(interleukin-6,IL-6)水平变化及临床意义。方法: 选取2016年2月至2020年8月收治的113例小儿肾母细胞瘤手术患儿,根据患儿术后是否发生明显手术应激反应和并发症分为预后欠佳组32例和预后良好组81例。检测两组患儿术前、术后1d、术后2d、术后3d的血清ACTH、Cor、ANP、IL-6水平。结果: 术后1d、术后2d、术后3d两组患者的血清ACTH、Cor、ANP、IL-6水平均高于术前(P<0.05),但预后欠佳组的血清ACTH、Cor、ANP、IL-6水平呈上升趋势(P<0.05),而预后良好组的血清ACTH、Cor、ANP、IL-6水平呈下降趋势(P<0.05),并且预后欠佳组术后1d、术后2d、术后3d的血清ACTH、Cor、ANP、IL-6水平均高于预后良好组(P<0.05)。结论: 小儿肾母细胞瘤手术后监测ACTH、Cor、ANP、IL-6有助于判断手术应激程度,ACTH、Cor、ANP、IL-6持续高水平可能意味着预后欠佳。

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	黄卿琛
	祁伯祥
	潘迪

关键词 ：小儿肾母细胞瘤, 促肾上腺皮质激素, 皮质醇, 心钠素, 白细胞介素-6

Abstract：Objective: To explore the changes and clinical significance of serum adrenocorticotropic hormone (ACTH), cortisol (Cor), atrial natriuretic peptide (ANP) and interleukin-6 (IL-6) levels before and after pediatric nephroblastoma surgery. Methods: A total of 113 children undergoing pediatric nephroblastoma surgery who were admitted from February 2016 to August 2020 were enrolled. According to presence or absence of postoperative surgical stress response and complications, they were divided into poor prognosis group (32 cases) and good prognosis group (81 cases). The levels of serum ACTH, Cor, ANP and IL-6 in both groups before surgery, at 1d, 2d and 3d after surgery were detected. Results: The levels of serum ACTH, Cor, ANP and IL-6 at 1d, 2d and 3d after surgery were higher than those before surgery in both groups (P<0.05), which showed increased trend in poor prognosis group (P<0.05), while showed decreased trend in good prognosis group (P<0.05). At 1d, 2d and 3d after surgery, levels of serum ACTH, Cor, ANP and IL-6 in poor prognosis group were higher than those in good prognosis group (P<0.05). Conclusion: Monitoring ACTH, Cor, ANP and IL-6 after pediatric nephroblastoma surgery is beneficial to determine surgical stress degree. Continuously high levels of ACTH, Cor, ANP and IL-6 may indicate poor prognosis.

Key words： Pediatric nephroblastoma Adrenocorticotropic hormone Cortisol Atrial natriuretic peptide Interleukin-6

基金资助:江苏省妇幼保健协会科研课题,(编号:FYX201912)

通讯作者: 祁伯祥

引用本文:

黄卿琛, 祁伯祥, 潘迪. 小儿肾母细胞瘤手术前后血清促肾上腺皮质激素皮质醇心钠素及白细胞介素-6水平变化及临床意义[J]. 河北医学, 2021, 27(5): 775-779.
HUANG Qingchen, QI Boxiang, et al. Changes and Clinical Significance of Serum Adrenocorticotropic Hormone, Cortisol, Atrial Natriuretic Peptide and Interleukin-6 Levels Before and After Pediatric Nephroblastoma Surgery. HeBei Med, 2021, 27(5): 775-779.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.05.016 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I5/775