目的  观察老年病人和非老年病人腹部大手术后应激反应的区别。方法  选择2013年2-4月南京军区南京总医院普外科需行胃肠道肿瘤手术病人73例，分为老年组（36例）和非老年组（37例），监测两组术前及术后第1、2、3天的生命体征、白细胞计数（WBC）、中性粒细胞比例（N）、C-反应蛋白（CRP）、血浆皮质醇（P-C）、促肾上腺素皮质激素（ACTH），并进行统计分析。结果  老年组术后第1天P-C明显高于非老年组（P=0.049）；老年组术后第1、2天CRP明显低于非老年组（P=0.046和0.008）；两组术后各时间点WBC、N、ACTH差异无统计学意义（P>0.05）。结论  行腹部大手术的老年病人术后应激激素血浆皮质醇的分泌较非老年病人明显增高，但其炎性反应却无明显增高甚至低于非老年病人。

Study of surgical stress on the aged abdominal major operation patients        ZHANG Juan-juan， GAO Tao，XI Feng-chan, et al. Research Institude of General Surgery，Nanjing General Hospital of Nanjing Military Command，PLA，Nanjing 210002，China
Corresponding：YU Wen-kui，E-mail：yudrnj@163.com
Abstact    Objective    To investigate the difference of surgical stress on the aged and non-aged abdominal major operation patients. Methods    From February to April in 2013，a prospective study was performed of abdominal operation patients with gastrointestinal neoplasms in research institude of general surgery, including 36 aged patients (≥65 years old) and 37 non-aged patients (＜65 years old). We observed differences of postoperative vital sign，white blood cell count，neutrophil proportion，C-reactive protein，plasma cortisol and ACTH in two groups，and analyzed these dates. Results    Compared with the non-aged group，plasma cortisol of the first day after operation in aged group was much higher，P=0.049. C-reactive protein of the first day and the second day after operation in aged group was much lower，P(D1)=0.046，P(D2)=0.008. There were no differences of white blood cell count，neutrophil proportion and ACTH in two groups. Conclusion    Compared with the non-aged patients，the stress hormone plasma cortisol of the aged abdominal major operation patients was much higher after operation，but the inflammatory reaction was not higher，and even lower.