免疫调节剂在外科感染及大手术中的作用机制探讨  

Role of immunotherapy in postoperative severe infection and great operation

作　　者：虞先浚[1] 徐近[1] 傅德良[1] 张群华[1] 倪泉兴[1] 

机构地区：[1]复旦大学附属华山医院外科,上海市200040

出　　处：《中华肝胆外科杂志》2004年第3期170-172,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　了解免疫调节剂胸腺肽α 1在外科感染及大手术中的作用机制。方法　分别选择 6 0例外科感染病人和 6 0例胰腺癌根治手术病人 ,分用药组和对照组。用药组病人在手术后使用胸腺肽α 1,对照组不使用免疫制剂。观察临床疗效、内毒素和细胞因子 (IL 2、IL 6、IL 10和TNF α)、T淋巴细胞亚群CD3+ 、CD4 + 、CD8+ 和NK细胞百分率的变化。结果　外科感染及胰腺癌病人无论用药组和对照组术后内毒素、IL 6和TNF α均呈下降趋势 ,IL 2和IL 10呈上升趋势 ,但用药组大部指标在术后 4d即达显著差异 ,术后 7d变化趋势更为明显。外科感染及胰腺癌病人用药组术后CD4 + /CD8+ 比值和CD4 + 百分率上升 ;同类病人术后用药组和对照组比较CD3+ 、CD4 + 百分率和CD4 + /CD8+ 比值较高。用药组临床疗效略高于对照组。结论　胸腺肽α 1在外科感染及重大手术中可提高免疫功能 ,有利于病人恢复。Objective To verify the feasibility of thymosin α-1 for the immunotherapy in patients of severe infection and undergoing great operation. Methods Sixty patients with severe infection and 60 patients with pancreatic cancer undergoing operation were divided into 2 groups of the thymosin α-1 treated group and the control group. The levels of endotoxin, IL-2, IL-10 and TNFα and expression of CD3+, CD4+, CD8+ and NK lymphocytes were determined. Results The levels of endotoxin, IL-6 and TNF( were decreased but those of IL-2 and IL-10 increased in both groups. However, there were significant differences in levels of most of the above indexes between 2 groups on the postoperative 4th d. On the 7th d after the operation, the differences became more significant. The percentage of CD4+ lymphocytes and the ratio of CD4+/CD+ 1 week after the operation were higher than those before the operation. After the operation, the percentages of CD3+ and CD4+ lymphocytes and the ratio of CD4+/CD8+ were higher in the thymosin α-1 treated group than in the control. Conclusions Thymosin α-1 can improve the immunological function in patients of severe infection and undergoing great operation.

关 键 词：免疫调节剂 外科感染 大手术 作用机制 巴细胞亚群 CD3^+ CD4^+ CD8^+ 

分 类 号：R605[医药卫生—外科学]