乌司他丁对肝癌患者高强度聚焦超声治疗后细胞免疫功能的影响  

Effect of ulinastatin on cellular immunity following high intensity focused ultrasound treatment in patients with liver cancer

作　　者：陈岗[1] 唐胜平 米卫东[1] 张宏[1] 

机构地区：[1]解放军总医院麻醉手术中心,北京市100853 [2]解放军三○七医院麻醉科

出　　处：《中华麻醉学杂志》2006年第11期980-982,共3页Chinese Journal of Anesthesiology

摘　　要：目的探讨乌司他丁对肝癌患者高强度聚焦超声(HIFU)治疗后细胞免疫功能的影响。方法择期行HIFU治疗的肝癌患者20例,ASAⅡ或Ⅲ级,随机分为2组(n=10):对照组(C组)和乌司他丁组(U组)。U组于麻醉诱导后缓慢静脉注射乌司他丁20万U,C组输注等量生理盐水。于HIFU治疗前即刻(T1)、治疗结束即刻(T2)及治疗结束后24 h(T3)采取肘静脉血样2 ml,使用流式细胞仪检测CD3+、CD4+、CD8+ T淋巴细胞和NK细胞百分率。结果与T1比较,C组T2、T3时CD3+、CD4+、CD8+ T淋巴细胞百分率差异无统计学意义(P>0．05),T2时CD4+／CD8+比值增高,T2、T3时NK细胞百分率增高(P<0．05),U组T2、T3时CD3+ T淋巴细胞百分率差异无统计学意义(P>0．05),T2时CD4+、CD8+ T淋巴细胞百分率增高(P<0．05),T2、T3时CD4+/CD8+比值、NK细胞百分率增高(P<0．01);与C组比较,T2、T3时U组NK细胞百分率增高(P<0．05)。结论乌司他丁可有效提高HIFU治疗肝癌患者的细胞免疫功能。Objective To investigate the effect of ulinastatin on the changes of cellular immunity following high intensity focused ultrasound （HIFU） treatment in patients with liver cancer.Methods Twenty ASA Ⅱ or Ⅲ patients of both sexes aged 40-65 yrs undergoing HIFU treatment for liver cancer under general anesthesia were randomly divided into 2 groups （ n = 10 each）, group U received intravenous infusion of ulinastatin 200 000 U in normal saline （NS） 100 ml after induction of anesthesia and group C received NS 100 ml. Blood samples were taken before （T1, baseline）, at the end of （T2） and 24 h after HIFU treatment （T3） for determination of the percentage of natural killer （NK） cells and T-lymphocyte subgroups CD3^＋ , CD4^＋ and CD8^＋ by flow cytometry. Results The two groups were comparable with respect to sex ratio, age, body weight, duration of operation and amount of fluid infused. There was no significant change in percentage of CD3^＋ after HIFU treatment in both groups. The percentage of CD4^＋ and CD8^＋ were significantly increased at T2 and T3 as compared with the baseline at T1 in group U while there was no significant change in the percentage of CD4^＋ and CD8^＋ after treatment in group C. The CD4^＋ / CD8^＋ ratio was significantly increased at T2 in group C and at T2 and T3 in group U as compared with the baseline at T1 . The percentage of NK cells was significantly increased at T2 and T3 as compared with that at T1 in both groups and was significantly higher in group U than in group C. Conclusion Ulinastatin can effectively enhance the immunity function of the patients undergoing HIFU treatment for liver cancer.

关 键 词：胰蛋白酶抑制剂 超声疗法 肝肿瘤 免疫 细胞 

分 类 号：R614[医药卫生—麻醉学]