手术应激与免疫抑制  

Surgical Stress and Immunosuppression

作　　者：彭聿平[1] 邱一华[1] 

机构地区：[1]南通大学基础医学院生理学教研室,江苏南通226001

出　　处：《生理科学进展》2006年第1期31-36,共6页Progress in Physiological Sciences

基　　金：江苏省高校自然科学研究重点项目(04KJA180110);南通市社会发展科技项目(S5040)资助课题

摘　　要：手术前后时期的心理应激和生理应激均可抑制细胞免疫功能,主要表现为T淋巴细胞和自然杀伤(natural killer,NK)细胞的数量减少和活性减弱。手术创伤越大,对免疫的抑制作用越强,因而对手术后的痊愈有明显影响。一般而言,手术应激所致的免疫抑制可以恢复,恢复的时间主要取决于手术创伤的大小。目前认为,手术引起免疫抑制的机制主要与下丘脑-垂体-肾上腺皮质轴、交感神经系统、细胞因子、阿片肽和T细胞信号分子有关。选用某些不具有免疫抑制作用的止痛药物,以及蛋白酶抑制剂,可以防治手术应激所致的免疫抑制作用。Perioperative psychological and physiological stress can suppress cell-mediated immunity, including the decrease of T lymphocytes and natural killer （NK） ceils in the number and activities. A stronger immunosuppression is found in larger postoperative stress than in smaller one, which may interfere with the recovery from the surgical hurt. Generally, the surgical stress-induced immunosuppression can recover, which depends on the degree of surgical injury. The mechanisms through which surgical stress induces the immunosuppression are closely related to hypothalamus-pituitary-adrenocortical axis, sympathetic nervous system, cytokines, opioids and T cell signal molecule. Some strategies may be used to prevent surgical stress-induced immunosuppression, which includes analgesic drugs devoid of immunosuppressive effects and protease inhibitor.

关 键 词：手术心理应激 手术生理应激 细胞免疫 细胞因子 下丘脑-垂体-肾上腺皮质轴 

分 类 号：R392[医药卫生—免疫学]