rhGH对梗阻性黄疸患者术后免疫功能的影响  

Influence of rhGH on postoperative immune function of patients with obstructive jaundice

作　　者：龚学东[1] 李善平[1] 张先林[1] 吴遵元[1] 陈季松[1] 

机构地区：[1]三峡大学仁和医院普外科,湖北省宜昌市443001

出　　处：《世界华人消化杂志》2009年第17期1791-1794,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨重组人生长激素(rhGH)对梗阻性黄疸患者术后免疫功能的影响及临床意义.方法:采用前瞻、随机、对照方法,对入选36例患者分为对照组(A组,n=18)、rhGH组(B组,n=18),B组加用rhGH,检测2组治疗前和治疗后1、8d细胞免疫指标(CD3+、CD4+、CD4+/CD8+)、体液免疫指标(IgM、IgA、IgG)和免疫调节因子(IL-2、IL-6、TNF-α)的动态水平,并观察2组患者并发症和病死率的变化.CD4+、CD4+/CD8+指标升高水平明显(42.32%±4.19%vs31.51%±4.42%;26.36%±4.25%vs19.29%±4.27%;1.22±0.20vs0.95±0.12,均P<0.05);IgA、IgG和IgM浓度明显升高(2.42±0.11g/Lvs1.41±013g/L;6.88±0.18g/Lvs4.89±0.15g/L;1.84±0.18g/Lvs1.28±0.24g/L,均P<0.05);IL-6和TNF-α下降明显(0.42±0.11μg/Lvs0.86±0.10μg/L;11.04±1.52pmol/Lvs18.24±1.22pmol/L,均P<0.05),IL-2浓度显著升高(1.92±0.15μg/Lvs1.14±0.12μg/L,P<0.05);B组并发症发生率和病死率明显低于A组(22.22%vs44.44%,0.00%vs5.56%,均P<0.05).结论:rhGH对梗阻性黄疸患者术后免疫功能具有直接的调理作用,能明显改善患者的免疫状态,有利于患者康复.AIM： To observe the clinical significance and changes of cytoimmunity, humoral immunity and immune regulatory factors after the administration of rhGH on patients with obstructive jaundice （OJ）. METHODS： A prospective, randomized and controlled clinical study was performed, and 36 OJ cases were randomly divided into control group （A group, n = 18） and rhGH group （B group, n = 18）. rhGH were added in group B. A dynamic investigation of cytoimmunity indices （CD3^＋, CD4^＋ and CD4^＋/CD8^＋）, humoral immunity indices （IgA, IgG and IgM） and serum immune regulatory factors （IL-2, IL-6 and TNF-α） were conducted and mortality rate and complication rate of patients of two groups before therapy and at 1, 8 d after operation were evaluated. RESULTS： Indexes of cytoimmunity indices （CD^3＋, CD^4＋ and CD^4＋/CD^8＋） in B group were obviously improved than A （42.32% ± 4.19% vs 31.51% ± 4.42%; 26.36% ± 4.25% vs 19.29% ± 4.27%; 1.22 ± 0.20 vs 0.95 ± 0.12, all P 〈 0.05）. Humoral immunity indices （IgA, IgG and IgM） in B group were obviously improved than group A 8 days after treatment （2.42 ± 0.11 g/L vs 1.41 ± 013 g/L; 6.88 ± 0.18 g/L vs 4.89 ± 0.15 g/L; 1.84 ± 0.18 g/L vs 1.28 ± 0.24 g/L, all P 〈 0.05）. Erum immune regulatory factors （IL-6 and TNF-α） were significantly decreased in B group （0.42 ± 0.11 μg/L vs 0.86 ± 0.10 μg/L; 11.04 ± 1.52 pmol/L vs 18.24 ± 1.22 pmol/L, both P 〈 0.05）, IL-2 was obviously improved in group B （1.92 ± 0.15 μg/L vs 1.14 ± 0.12 μg/L, P 〈 0.05）, and mortality rate and complication rate in group B were obviously lower than group A （22.22% vs 44.44%, 0.00% vs 5.56%, both P 〈 0.05）. CONCLUSION： RhGH has a direct immunoregulatory effect on patients with obstructive jaudice, which improves immunity of patients with obstructive jaundice and is good for their recovery.

关 键 词：梗阻性黄疽 生长激素 免疫功能 随机对照研究 

分 类 号：R657.4[医药卫生—外科学]