摘要
目的研究梗阻性黄疸免疫功能及其与内毒素血症的相关性．方法检测２８例梗阻性黄疸患者及２０例健康对照者血清内毒素，Ｔ淋巴细胞亚群及血清ＳＩＬ２Ｒ的水平．结果梗阻性黄疸患者血清内毒素和ＳＩＬ２Ｒ水平较对照组明显升高（４７０ｎｇ／Ｌ±１１３ｎｇ／Ｌ和７２５ｋＵ／Ｌ±２０１ｋＵ／Ｌｖｓ２８４ｎｇ／Ｌ±１０３ｎｇ／Ｌ和３２４ｋＵ／Ｌ±１１６ｋＵ／Ｌ，Ｐ＜００１），Ｔ淋巴细胞亚群ＣＤ３，ＣＤ４，ＣＤ４／ＣＤ８明显降低（５０４％±３３％和２９９％±３８％ｖｓ６３８％±４４％和３８３％±２８％，Ｐ＜００１；１２２±０３２ｖｓ１４３±０３７，Ｐ＜００５），同时亦发现梗阻性黄疸内毒素血症组较非内毒素血症组ＣＤ３，ＣＤ４水平明显减低，ＳＩＬ２Ｒ水平明显升高（４７４％±５１％和２７６％±５２％和８６７ｋＵ／Ｌ±２３１ｋＵ／Ｌｖｓ５２３％±５２％和３１２％±４３％和６７４ｋＵ／Ｌ±１８９ｋＵ／Ｌ，Ｐ＜００５）．相关分析显示血清内毒素水平与血清ＳＩＬ２Ｒ水平呈显著正相关（ｒ＝０８５１７，Ｐ＜００１）．结论梗阻性黄疸时内毒素血症与免疫功能状态密切相关．
AIM To investigate the relationship between endotoxemia and cellular immunity in patients with obstructive jaundice. METHODS Serum endotoxin levels, Tlymphocyte subsets, and serum soluble interleukin 2 receptor (SIL 2R) were studied in 28 patients with obstructive jaundice and 20 controls. RESULTS The serum endotoxin levels and SIL 2R were significantly higher ( 47 0ng/L ± 11 3ng/L and 725kU/L ± 201kU/L vs 28 4ng/L ± 10 3ng/L and 324kU/L ± 116kU/L , P <0 01) and CD3 , CD4 , CD4/CD8 were much lower (50 4%±3 3% and 29 9%±3 8% vs 63 8%±4 4% and 38 3%±2 8%, P <0 01; 1 22±0 32 vs 1 43±0 37, P <0 05) than those of controls. CD3 , CD4 and SIL 2R in endoto xemia group with obstructive jaundice were significantly diferent from the non endotoxemia group (47 4%±5 1% and 27 6%±5 2% and 867kU/L ± 231kU/L vs 52 3%±5 2% and 31 2%±4 3% and 674kU/L ± 189kU/L , P <0 05). Serum endoto xin levels were positively correlatied with SIL 2R ( r =0 8517, P <0 01). CONCLUSION Endotoxemia is closely related to the status of cellular immunity in patients with obstructive jaundice.
关键词
黄疸
内毒素类
T淋巴细胞亚群
jaundice/immunology
cholestasis/immunology
endotoxins/blood
immunity, cellular
common bile duct neoplasms
pancreatic neoplasms
bile duct neoplasms
lymphocyte subsets
receptors, interleukin 2
