肛瘘病人手术前后血清中IgA、血清淀粉蛋白A、趋化因子5和炎性因子水平变化与肛门功能及疗效的关系

doi:10.3969/j.issn.1005-6483.2020.05.017

摘要/Abstract

摘要： 目的:探讨肛瘘病人手术前后血清中IgA、血清淀粉蛋白A（SAA）、趋化因子5（CCL5）和炎性因子水平变化与肛门功能及疗效的关系。方法:2017年10月～2019年1月我院收治的肛瘘病人114例，所有病人均接受手术治疗。采用酶联免疫吸附法检测血清中IgA、SAA、CCL5和白细胞介素（IL）4、IL6及IL10水平，比较手术前后血清中IgA、SAA、CCL5和IL4、IL6及IL10炎性因子水平变化与肛门功能和手术效果的关系。结果:治疗后，病人IgA、SAA、CCL5、IL4、IL6和IL10水平、Wexner评分均显著下降，差异有统计学意义（P<0.05）；术后IgA、SAA、CCL5、IL4、IL6及IL10低水平组病人的手术效果比高水平组更好，差异有统计学意义（P<0.05）；IgA、SAA、CCL5、IL4、IL6和IL10与病程、Wexner 评分呈正相关（P＜0.05），与治疗效果呈负相关（P<0.05）。结论:肛瘘病人手术后血清中IgA、SAA、CCL5和炎性因子水平均低于手术前，血清中IgA、SAA、CCL5和炎性因子水平与手术效果和病人术后肛门功能密切相关。

关键词: 肛瘘, 免疫球蛋白A, 血清淀粉蛋白A, 趋化因子5, 炎性因子, 肛门功能

Abstract: Objective:To explore changes of serum IgA，SAA，CCL5 and inflammatory cytokines in patients with anal fistula before and after operation and their relationship with anal function and efficacy.Methods:114 anal fistula patients admitted to our hospital from October 2017 to January 2019 were selected as research objects，all of whom received surgical treatment.The serum levels of IgA，SAA，CCL5 and IL4，IL6 and IL10 were detected by enzymelinked immunosorption method.The changes in serum levels of IgA，SAA，CCL5 and IL4，IL6 and IL10 and the anal function scores of patients before and after surgery were compared to explore the relationship between serum IgA，SAA，CCL5 and IL4，IL6 and IL10 and the anal function and surgical effect of patients.Results:After treatment，the levels of IgA，SAA，CCL5，IL4，IL6，IL10 and Wexner scores of the patients were significantly decreased（P<0.05），and the differences were statistically significant（P<0.05）.Postoperative effects of IgA，SAA and CCL5 patients in the low level group were better than those in the high level group，with statistically significant differences（P<0.05）.Patients in the lowlevel IL4，IL6 and IL10 group were better than those in the highlevel group，with statistically significant differences（P<0.05）.IgA，SAA，CCL5，IL4，IL6 and IL10 were positively correlated with the course of disease and Wexner score（P<0.05），and negatively correlated with the treatment effect（P<0.05），but had no significant correlation with gender or age（P>0.05）.Conclusion:The serum levels of IgA，SAA，CCL5 and inflammatory factors in patients with anal fistula after surgery are all lower than those before surgery.The serum levels of IgA，SAA，CCL5 and inflammatory factors are closely related to the operation effect and postoperative anal function of patients.

Key words: anal fistula, IgA, serum amyloid A, chemotactic factor 5, anal function

梁艳. 肛瘘病人手术前后血清中IgA、血清淀粉蛋白A、趋化因子5和炎性因子水平变化与肛门功能及疗效的关系[J]. 临床外科杂志, 2020, 28(5): 460-463.

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