腹腔镜手术对妇科良性疾病患者吞噬细胞和红细胞免疫功能的影响  

Effect of laparoscopic surgery on human phagocyte & erythrocyte immune activities of patients with benign gynecologic disorders

作　　者：李雅钗[1] 黄向华[1] 王亚男[1] 

机构地区：[1]河北医科大学第二医院妇产科,河北石家庄050000

出　　处：《中国内镜杂志》2007年第8期785-788,共4页China Journal of Endoscopy

摘　　要：目的该研究旨在探讨腹腔镜手术对妇科良性疾病患者吞噬细胞和红细胞免疫功能的影响,并与开腹手术进行对比,期望为腹腔镜技术的微创性提供更多的依据。方法选取因妇科良性疾病行腹腔镜手术(LS组)或开腹手术(OS组)治疗的患者共60例,两组分别为32例和28例。分别检测两组患者在术前24h、术后24h和术后72h白细胞计数及中性粒细胞百分比、白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平、以及反映红细胞免疫功能的红细胞表面受体CR1(CD35)的表达、红细胞C3b受体花环率(C3bRR)、红细胞免疫复合物花环率(ICR)等指标的变化。结果两组患者术后24h白细胞计数和中性粒细胞百分比[OS组:(5.22±1.31)vs(10.33±2.37),P1<0.05;(56.38±9.73)vs(81.76±5.79),P2<0.05。LS组:(5.66±1.48)vs(7.81±1.75),P3<0.05,(56.64±9.72)vs(75.38±10.79),P4<0.05]、IL-6[OS组:(3.14±0.98)vs(26.72±15.59),P1<0.05;LS组:(3.29±1.25)vs(17.94±10.93),P2<0.05]和TNF-α水平均明显升高[OS组:(54.83±17.99)vs(80.70±15.32),P1<0.05;LS组:(54.39±11.19)vs(76.16±19.71),P2<0.05],但腹腔镜组白细胞[(7.81±1.75)vs(10.33±2.37),P24h<0.05;(5.88±1.28)vs(7.12±1.32),P72h<0.05]和IL-6水平升高幅度[(17.94±10.93)vs(26.72±15.59),P<0.05]低于开腹组。腹腔镜组患者红细胞表面CD35和C3bRR在手术前后均无显著变化(P>0.05),开腹组术后24hC3bRR降低显著[(22.05±2.11)vs(16.10±1.31),P<0.05],到术后72h尚未恢复到术前水平[(22.05±2.11)vs(16.15±2.93),P<0.05]。手术前后ICR在组间和组内变化不显著(P>0.05)。结论腹腔镜手术对良性妇科疾病患者吞噬细胞免疫功能抑制程度轻,对机体红细胞免疫功能无明显影响。[Objective] In order to provide further evidences for minimum incisions induced by the laparoscopic procedures. This study was designed to evaluate the effect of laparoscopic surgery on the host immune response in patients with benign gynecologic disorders required to operation and finds its advantages by comparing with open surgery. [Methods] Sixty patients with benign gynecologic disorders required to surgery were assigned to laparoscopic surgery （LS, n =32） and open surgery （OS, n =28）. White blood cell count and its kinds, serum concentrations of IL-6 and TNF-α and erythrocyte immune function were determined at 24 h preoperatively, 24 h and 72 h postoperatively, respectively. [Results] In both groups, these parameters including WBC count [OS group：（5.22±1.31） vs （10.33±2.37）, P 〈0.05, LS group： （5.66±1.48） vs （7.81±1.75）, P 〈0.05], neutrophil proportion [OS group： （56.38± 9.73） vs （81.76±5.79）, P 〈0.05, LS group： （56.64±9.72） vs （75.38±10.79）,P 〈0.05], the values of IL-6 [OS group： （3.14±0.98） vs （26.72±15.59）, P 〈0.05; LS group： （3.29±1.25） vs （17.94±10.93）, P 〈0.05] and TNF-α [OS group： （54.83±17.99） vs （80.70±15.32）, P 〈0.05; LS group： （54.39±11.19） vs （76.16±19.71）, P 〈0.05] significandy increased at postoperative 24 h compared with preoperative level and decreased at postoperative 72 h. But increasing degree of WBC [（7.81±1.75） vs （10.33±2.37）, P24h 〈0.05; （5.88±1.28） vs （7.12±1.32）, P72h 〈0.05] and IL-6 [（17.94±10.93） vs （26.72±15.59）, P 〈0.05] was lower in laparoscopy group than that in laparotomy group significantly at postoperative 24 h. The values of CD35 expression and C3bRR hadn＇t obvious change in patients who underwent laparoscopic approach before and after surgery （P 〉0.05）. The values of C3bRR went down dramatically at postoperative 24 h [（22.05±2.11） vs （16.10±1.31）, P 〈0.05], and returned to a lower level at postoper

关 键 词：腹腔镜手术 开腹手术 细胞免疫功能测定 免疫学检验方法 

分 类 号：R446.6[医药卫生—诊断学]