CAJ | 학술논문

目的：探讨梗阻性黄疸和胆囊结石患者血小板活化依赖性表面膜蛋白（CD62p）的动态变化及其意义。方法选取2010年4月－2013年10月兰州大学第二医院收治的胆石症患者108例。其中58例胆总管结石并有黄疸患者为梗阻性黄疸组，50例胆囊结石患者为胆囊结石组。2组患者分别于术前3 d、术中、术后3、6、9、12、15、18、21 d抽取外周静脉血，酶联免疫吸附法测定血浆CD62P含量。2组计量资料的比较采用t检验。结果梗阻性黄疸患者术前3 d至术后18 d血浆CD62P浓度均高于同期胆囊结石患者（P值均＜0．01）。胆囊结石患者血浆CD62P术中、术后进行性升高，术后3 d最高，术后9 d降至术前水平。梗阻性黄疸患者血浆CD62P浓度术后9 d达最高，然后进行性下降，至术后18 d达术前水平，术后21 d达胆囊结石患者术前水平。结论胆道梗阻可致血管内皮细胞损伤和血小板活化，梗阻解除后，血管内皮细胞损伤和血小板活化改善。梗阻性黄疸手术较胆囊结石手术可致较重的血管内皮细胞损伤和血小板活化。
목적：탐토경조성황달화담낭결석환자혈소판활화의뢰성표면막단백（CD62p）적동태변화급기의의。방법선취2010년4월－2013년10월란주대학제이의원수치적담석증환자108례。기중58례담총관결석병유황달환자위경조성황달조，50례담낭결석환자위담낭결석조。2조환자분별우술전3 d、술중、술후3、6、9、12、15、18、21 d추취외주정맥혈，매련면역흡부법측정혈장CD62P함량。2조계량자료적비교채용t검험。결과경조성황달환자술전3 d지술후18 d혈장CD62P농도균고우동기담낭결석환자（P치균＜0．01）。담낭결석환자혈장CD62P술중、술후진행성승고，술후3 d최고，술후9 d강지술전수평。경조성황달환자혈장CD62P농도술후9 d체최고，연후진행성하강，지술후18 d체술전수평，술후21 d체담낭결석환자술전수평。결론담도경조가치혈관내피세포손상화혈소판활화，경조해제후，혈관내피세포손상화혈소판활화개선。경조성황달수술교담낭결석수술가치교중적혈관내피세포손상화혈소판활화。
Objective To analyze and study the implication of dynamic changes in plasma CD62P among patients with obstructive jaundice and cholecystolithiasis.Methods A total of 58 patients diagnosed with choledocholithiasis and jaundice were included in the obstructive jaundice group,and 50 patients were in the cholecystolithiasis group.Peripheral venous blood was collected on preoperative day 3,on opera-tive day,and on postoperative days 3,6,9,12,15,18,and 21 in two groups,and the concentrations of plasma CD62P were measured by ELISA.Comparison of continuous data between the two groups was made by t test.Results The concentrations of plasma CD62P from preop-erative day 3 to postoperative day 18 were significantly higher in the obstructive jaundice group than in the cholecystolithiasis group (P<0.01 across all time points).In the cholecystolithiasis group,the concentrations of plasma CD62P significantly increased on operative day, and the increase continued and reached the peak on postoperative day 3,then followed by a decrease down to the preoperative level on post-operative day 9.In the obstructive jaundice group,the concentrations of plasma CD62P reached the peak on postoperative day 9,followed by a gradual decrease down to the preoperative level on postoperative day 18 and to an even lower level (preoperative level of patients with cho-lecystolithiasis)on postoperative day 21.Conclusion Extrahepatic biliary obstruction may lead to endothelial cell injury and platelet acti-vation,the condition of which is improved with the relief of obstruction.The surgery for obstructive jaundice may lead to much more endothe-lial cell injury and higher platelet activation than that for cholecystolithiasis.