结直肠癌围术期患者免疫功能状态及黄芪注射液的调节作用  

Comparison of Perioperative Immune Function Status in Colorectal Cancer Patients and Immune Regulatory Function of Drugs

作　　者：季锡清[1] 杜峻峰[1] 陈纲[1] 盛新华[2] 于波[1] 

机构地区：[1]北京军区总医院,100700 [2]解放军第150医院全军肛管外科研究所,471031

出　　处：《实用癌症杂志》2011年第4期331-334,共4页The Practical Journal of Cancer

基　　金：国家自然科学基金青年科学基金项目(81000189)

摘　　要：目的研究结直肠癌患者围术期的免疫功能状态和调节免疫功能的治疗方法。方法应用免疫细胞化学法和生化法,检测28例健康体检者和128例结直肠癌患者围术期T细胞亚群、自然杀伤细胞NK、IgG、白细胞介素2(IL-2)及血清可溶性白细胞介素2受体(sIL-2R)的水平;比较黄芪注射液对围术期患者免疫功能的影响。结果结直肠癌患者术前CD3、CD4细胞水平、CD4/CD8比值、NK和IL-2活性明显低于健康体检者(P<0.01),血浆sIL-2R、CD8和IgG水平较正常人显著增高(P<0.01),术后3周CD3、CD4细胞水平、CD4/CD8值、NK和IL-2活性较术前明显升高,血浆sIL-2R、CD8和IgG水平较术前降低;T细胞亚群、sIL-2R和IL-2活性与结直肠癌临床分期有关;应用黄芪注射液治疗的患者术后CD3、CD4细胞水平、CD4/CD8比值、NK和IL-2活性较未治疗组明显增高(P<0.01),术后T细胞亚群、sIL-2R和IL-2活性接近健康对照组。结论结直肠癌患者切除肿瘤后全身免疫机能状况有所改善,肿瘤患者的T细胞亚群水平和血浆sIL-2R和IL-2活性可反映机体的免疫状况,并可判断病情、指导临床治疗;黄芪注射液能有效改善围术期结直肠癌患者的免疫功能状态。Objective To evaluate the perioperative immune function status of patients with colorectal carcinoma（CRC） and study the therapy methods to regulate the immune function.Methods T-lymphocyte subsets,natural killer cell（NK）,immunoglobulin G（IgG）,interleukin-2（IL-2） and the plasma levels of soluble inter leukin-2 receptors（sIL-2R） were determined from 128 CRC patients and 28 healthy controls by the biochemistry method respectively.The treatment effect on immune was compared between perioperation and Astragalus membranaceus.Results The CD3,CD4,CD4/CD8 ratio,NK and IL-2 were significantly lower in CRC patients before operation than those in the controls,while the plasma sIL-2R,CD8 and IgG were much higher in cancer patients.The CD3 cells,CD4 cells,CD4/ CD8 ratio,NK as well as IL-2 increased remarkably post operatively,while the plasma sIL-2R,CD8 and IgG decreased.Furthermore,these data were related with CRC TNM stages.Compared the administration with no-administration postoperation,CD3,CD4,CD4/CD8 ratio,NK and IL-2 were significantly higher in CRC patients treated with Chinese herbs before operation than those in without Chinese herbs,while T-lymphocyte subsets,the plasma sIL-2R as well as IL-2 were near healthy controls.Conclusion The immune status of CRC patients was somewhat depressed and closely related with TNM stage,after curative resection,the cellular immunity improved.Measurement the T-lymphocyte subsets,plasma sIL-2R,NK as well as IL-2 can show the immune status,and may be beneficial to guide adjuvant therapy.Astragalus membranaceus can improve the immune status of CRC patients.

关 键 词：结直肠癌 围术期 免疫 药物治疗 

分 类 号：R735.35[医药卫生—肿瘤]