血清サイトカインからみた脊椎手術の侵襲度

Serum Cytokine Response after Spinal Surgery. Estimation of Surgical Magnitude

　近年Interleukin-6（IL-6）などの炎症性サイトカインを用いて，術後の生体反応の大きさから手術侵襲の程度を推測する方法が有用と報告されている．今回，サイトカインからみた種々の脊椎手術の侵襲度を検討した．脊椎手術において血清IL-6値は術後1日でピークを示した．また，血清IL-6は局所の筋損傷の指標となるCPKや，全身生体反応の程度を表すCRPと相関した．また，従来の指標とされた出血量や手術時間とも相関を示し，脊椎手術侵襲の客観的指標となりえた．

　The serum IL-6 level was used to try for estimating quantitative marker of surgical magnitude of major cardiac and thoracoabdominal surgery. We investigated changes in IL-6 response in comparison with other parameters of surgical magnitude and surgical procedures in spinal surgery. The serum IL-6 level was peaked on the first day. The peak IL-6 level was significantly correlated with CRP, CPK, operation time, and blood loss. CRP reflects the extent of the systemic response, and CPK reflects the extent of the local soft tissue damage. The results suggested that the IL-6 level reflected the reaction of the both systemic and local response which was surgical magnitude of spinal surgery.