| Objective :To investigate the change of growth hormone ,somatostatin and endotoxin level and their correlation in blood of obstructive jaundice patients.Clarify the pathophysiological change of the obstructive jaundice,evaluate the clinical significance of the changes of growth hormone and somatostatin level in blood of obstructive jaundice patients .Methods: 50 obstructive jaundice patients were divided into two groups, benign obstructive jaundice group(n=25)and malignant obstructive jaundice group(n=25).Growth hormone,somatostatin and endotoxin level in blood of them were measured on the last day before operation and the 7th day after operation . 25 patients with simple gallbladder stone operated with cholecystectomy were chosen as control group.Results: (1)The preoperative endotoxin level of benign obstructive jaundice group and malignant obstructive jaundice group[(0.42±0.26)Eu/ml,(1.11±0.56) Eu/ml]were significantly higher than that of control group [(0.06±0.02 )Eu/ml]( p<0.01),and the endotoxin level of the malignant group was higher than that of the benign group(p<0.05)；the postoperative endotoxin level of the benign and the malignant group [(0.09±0.04)Eu/ml,(0.08±0.03)Eu/ml]both decreased obviously in comparison with that of the same group preoperation(p<0.01) ,but still higher than that of control group [(0.05±0.02) Eu/ml)](p<0.05).The difference of postoperative endotoxin level between the benign and the malignant group was insignificant(p＞0.05). (2)The preoperative growth hormone level of the benign and the malignant group [(1.81±0.91)ng/ml,(1.84±0.87)ng/ml] were lower than that of control group (7.14±1.21)ng/ml(p<0.05).The difference of preoperative growth hormone level between the benign and the malignant group was insignificant (p＞0.05);the postoperative growth hormone level of the benign and the malignant group [(6.49±1.13)ng/ml,(6.34±1.39)ng/ml]both increased in comparison with that of the same group preoperation(p<0.01),and the difference of preoperative growth hormone level among the three groups was insignificant(p＞0.05).(3)The preoperative soamtostatin level of the benign and the malignant group [(46.02±14.94)pg/ml,(54.11±14.67)pg/ml] were higher than that of control group (18.15±4.40)pg/ml(p<0.05),the difference of preoperative somatostatin level between the benign and the malignant group was insignificant (p＞0.05)；the postoperative soamtostatin level of the benign and the malignant group [(17.83±3.76)pg/ml,(18.64±3.75)pg/ml]both decreased obviously in comparison with that of the same group preoperation(p<0.01) ,and the difference of preoperative somatostatin level among the three groups was insignificant(p＞0.05).(4)Correlation analysis:①The preoperative endotoxin content of the benign and the malignant group both were positively correlative with total bilirubin(TB) and alanine aminotransferase(ALT)( p<0.01). ②The preoperative growth hormone level of the benign group was negatively correlative with endotoxin content and TB, but incorrelative with ALT; the preoperative growth hormone level of the malignant group was incorrelative with TB,ALT and endotoxin level (p<0.01).③The preoperative somatostatin level of the benign group was positively correlative with TB,ALT and endotoxin level and was negatively correlative with growth hormone level;the preoperative somatostatin level of the malignant group was incorrelative with TB,ALT,endotoxin level and growth hormone(p<0.01).④After operation growth hormone,somatostatin ,endotoxin,TB,ALT had no correlation with each other in three groups(p<0.01).Conclusions:Endotoxmia occurs in obstructive jaundice patients constantly ,and the endotoxin level in blood of malignant obstructive jaundice patients is higher than that in benign ones .Obstructive jaundice can cause the decline of growth hormone level and the ascendance of somatostatin level .The growth hormone level of benign obstructive jaundice patients is negatively correlative with somatostatin level,TB and endotoxin level... |
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