血清IL-2和SIL-2R在胆道梗阻围手术期中的变化及精氨酸治疗的研究

[Objective] To evaluate serum interleukin-2(IL-2) and soluble interleukin-2 receptor(SIL-2R) concentration and its clinical significance in patients with biliary obstruction and the immune adjustment of arginine. [Methods] The patients with biliary obstruction were divided into benign group and malignant group, serum IL-2 and SIL-2Rconcentrations of the two groups were dynamically measured in 30 patients with biliary obstruction by radioimmunoassay and ELISA. 25 benign patients with biliary obstruction were treated in seven days by arginine, to observe the changes of preoperative serum IL-2 and SIL-2R concentrations. [Results] Preoperative serum IL-2 concentration of the two groups was significantly lower but the level of SIL-2R was siginificantly higher than those of normal control subjects while postoperative serum levels of IL-2 and SIL-2R resume gradually. But there was a significant differece in the trend between benign and malignant icteric patients. The rank correlation analysis showed a relationship between the serum level of bilirubin and serum levels of IL-2 and SIL-2R. 12 days after operation, serum IL-2 and SIL-2R concentration of the benign patients treated by external biliary drainge didn't come back as compared to those by internal biliary drainage. Arginine can advance significantly serum level of IL-2, restrain serum SIL-2R concentration of the benign patients with biliary obstruction. [Conclusions] There exist low activity of IL-2 and high expression level of SIL-2R in patients with biliary obstruction. Examination of serum IL-2 and SIL-2R comcentration might be a valuable parameter of estimating patientis conditions, assessing patients prognosis and identifying the nature of biliary obstruction. The recovery of IL-2 and SIL-2R concentration by external biliary drainage is relatively slow, which might be related to bacterial translocation and enterogenous endoximia. Arginine might take the immune adjustment effects on the biliary obstructive cases by elevating serum activity of IL-2, inhibiting high expressive level of SIL-2R.