摘要
目的研究经内镜置支架内引流对晚期恶性梗阻性黄疸体液免疫、T淋巴细胞亚群及IL-2,IL-6,sIL-2R和TNF的影响。方法选择临床上恶性梗阻性黄疸经十二指肠镜置支架内引流患者共18例为A组,设10例健康老年人为B组,A组分别于术前1 d、术后3,7和10 d及B组采集晨起空腹外周静脉血测定血清IgA,IgG和IgM的浓度、T细胞亚群CD3+,CD4+,CD8+和SIL-2R,IL-6,IL-2,TNF的浓度。结果A组与术前1 d相比术后3 d IgA,IgG,IgM,TNF,SIL-2R下降,CD4+,CD8+,CD4+/CD8+回升,术后7 d IgG,IL-6,SIL-2R,TNF进一步下降(P<0.01);术后7 d CD3+、CD4+、CD8+、CD4+/CD8+、IL-2进一步回升,与术前相比意义显著,术后10 d CD4+/CD8+升高明显;IgG和SIL-2R进一步下降;术后第10天除免疫球蛋白外与B组相比差别显著。结论术后7 d免疫功能得到明显提高,术后10 d各免疫指标进一步恢复。经内镜内引流术后10 d仍不能达到正常水平,可能与肿瘤的继续作用有关,因此,应加用免疫调节剂或中药进一步增强免疫功能。
Objectives: To observe influence of stents by endoscopy on humoral immunity and T-cell subsets and IL-2, IL-6, sIL-2R, TNF concentrations in patients with advanced malignant obstructive jaundice(MOJ). Methods: 18 cases of MOJ were selected as group A and 10 old healthy men were selected for normal control group B. Peripheral blood was extracted on morning. Results: To 1 day pre-operation, IgA, IgG, IgM, TNF and SIL-2R concentrations decreased and CD4+, CD8+ and CD4+/CD8+ increased in 3 day past-operation, IgG, IL-6, SIL-2R and TNF were much lower and CD3+, CD4+, CD8+, CD4+/CD8+ and IL-2 increased in 7 day than in 3 day past-operation in group A. CD4+/CD8+ increased IgG, SIL-2R decreased much more in 10 day than in 7 day past-operation. There was a significant difference between 10 day past-operation in group A and in group B excluding immunoglobulin. Conclusions: Immune function improved effectively in group A in 7 day post-operation, but it did not recover to normal in group A in 10 day post-operation and it probably caused by tumour′s process. Therefore, immune regulator and Chinese traditional medicine could be used to enhance immune function.
出处
《中国内镜杂志》
CSCD
2004年第10期7-9,共3页
China Journal of Endoscopy
