CAJ | 학술논문

目的：探讨直肠癌患者术后疼痛程度与血清补体C3、C4水平的变化趋势及两者相关性。方法选择择期行直肠癌根治术患者100例，视觉模拟量表（VAS）评分测量患者术前12 h及术后4、8、12、24、48、72、120 h疼痛强度；同一时点采集患者外周静脉血，采用免疫比浊法测定血清补体系统中C3、C4含量。结果与术前12 h比较，患者的VAS评分在术后4、8、12、24、48、72 h明显增高（ P＜0．01）；术后120 h恢复至术前水平。与术前12 h比较，患者术后的血清C3、C4水平在术后4、8、12、24、48 h明显降低（P＜0．01），术后72 h恢复至术前水平。VAS分值与血清补体C3水平呈明显负相关（r＝-0．622，P＜0．01），与血清补体C4水平亦呈明显负相关（ r＝-0．649，P＜0．01）。结论术后疼痛能激活血清中的补体系统，降低血清补体C3、C4水平，从而抑制机体的免疫反应。
목적：탐토직장암환자술후동통정도여혈청보체C3、C4수평적변화추세급량자상관성。방법선택택기행직장암근치술환자100례，시각모의량표（VAS）평분측량환자술전12 h급술후4、8、12、24、48、72、120 h동통강도；동일시점채집환자외주정맥혈，채용면역비탁법측정혈청보체계통중C3、C4함량。결과여술전12 h비교，환자적VAS평분재술후4、8、12、24、48、72 h명현증고（ P＜0．01）；술후120 h회복지술전수평。여술전12 h비교，환자술후적혈청C3、C4수평재술후4、8、12、24、48 h명현강저（P＜0．01），술후72 h회복지술전수평。VAS분치여혈청보체C3수평정명현부상관（r＝-0．622，P＜0．01），여혈청보체C4수평역정명현부상관（ r＝-0．649，P＜0．01）。결론술후동통능격활혈청중적보체계통，강저혈청보체C3、C4수평，종이억제궤체적면역반응。
Objective To explore the trend of variation and relationship of postoperative pain and serum complement C 3 and C4 in cancer patients undergoing rectum surgery .Methods 100 patients ,who were scheduled for rectum carcinoma surgery ,were se-lected to the study .Pain was assessed by a visual analog scale at 12 h before operation and 4 ,8 ,12 ,24 ,48 ,72 ,120 h after surgery . The blood samples were obtained at the same time .The contents of serum complement C3 and C4 were determined by immunoturbi-dimetry .Results The VAS values in 4 ,8 ,12 ,24 ,48 ,72 h post-operation were significantly higher than 12 h pre-operation(P<0 .01) ,and in 120 h post-operation returned to 12 h pre-operation level .Compared with 12 h pre-operation ,the contents of serum complement C3 and C4 in 4 ,8 ,12 ,24 ,48 h post-operation were significantly decreased (P<0 .01) .The contents of serum comple-ment C3 and C4 returned to 12 h pre-operation level in 72 h post-operation .The results of correlative study on VAS values and the contents of serum complement C3 showed a negative correlation(r= -0 .622 ,P<0 .01) .The results of correlative study on VAS values and the contents of serum complement C4 also showed a negative correlation(r= -0 .649 ,P<0 .01) .Conclusion Postoper-ative pain can induce complement activation ,reduce the levels of serum complement C3 and C4 ,and inhibit immunoreactions .