乌司他丁对腹腔镜手术患者术后Teff细胞和Treg细胞免疫功能的影响  

Effect of Ulinastatin on Teff and Treg cellular immune function after laparoscopic surgery

作　　者：张先杰[1] 廖欧 郭红利[1] 

机构地区：[1]德阳市人民医院麻醉科,四川德阳618000

出　　处：《海南医学院学报》2014年第9期1220-1222,共3页Journal of Hainan Medical University

基　　金：四川省技术创新资助项目(2012CD02358)~~

摘　　要：目的:探讨乌司他丁对腹腔镜手术患者术后效应性T淋巴细胞(Teff细胞)和调节性T淋巴细胞(Treg细胞)免疫功能和细胞因子转化生长因子-β(TGF-β)和干扰素-γ(IFN-γ)的影响。方法:选择肝胆外科90例择期行腹腔镜胆囊切除患者,按患者入院顺序单双号随机分为观察组和对照组,每组45例。观察组麻醉前15min给予40万单位乌司他丁溶于100mL生理盐水静注,对照组给予等量生理盐水静注。于术前、术后1d和术后5d取患者肘中静脉血送检,流式细胞仪检测Teff细胞和Treg细胞,酶联免疫吸附法(ELISA)检测TGF-β和IFN-γ。结果:对照组Teff细胞手术前后比较无明显差异(P>0.05),观察组术后5d显著高于术前和对照组(P<0.05);对照组Treg细胞术后1、5d显著高于术前(P<0.05),观察组手术前后比较无明显差异(P>0.05),观察组术后不同时间点Treg细胞显著低于对照组(P<0.05)。对照组TGF-β术后1、5d显著高于术前,观察组术后1、5d显著低于术前,且观察组术后不同时间点均显著低于对照组,差异均有统计学意义(P均<0.05);对照组IFN-γ术后1、5d显著低于术前,观察组术后5d显著高于术前,且观察组术后不同时间点均显著高于对照组,差异均有统计学意义(P均<0.05)。结论:乌司他丁用于腹腔镜手术,可以增强Teff细胞免疫功能,维持Teff细胞和Treg细胞免疫平衡,其作用机制可能与调节细胞因子TGF-β和IFN-γ有关。Objective： To explore the effect of Ulinastatin on Teff, Treg cellular immune function and cytokines TGF-β, IFN-γ after laparoscopic surgery. Methods：A total of 90 gallbladder removal patients undergoing elective laparoscopic surgery were selected, and were randomly divided into observation group and control group by half. In 15 minutes before anesthesia, patients in observation group were treated with 400 000 units ulinastatin dissolving in 100 mL saline static note, while patients in control group were given amount of saline injection. Respectively before surgery, 1 d and 5 d after surgery, the Teff cells and Treg cells was determined with flow cytometry instrument, the IFN-γand TGF-β with ELISA methods. Results： There was no significant difference before and after surgery in Teff cells of control group（P〉0.05）, Teff cells in observation group 5d after surgery was significantly higher those before operation and the control group （P〈0.05） Treg cells in control group 1 d and 5 d after surgery was significantly higher than those before operation （P〈0.05）, while there was no significant difference before and after surgery in Treg cells of observation group（P〉0.05）. Treg cells in observation group at different time points after surgery were significantly lower than in control group （P〈0.05）. TGF -β in control group 1 d and 5 d after surgery was significantly higher than that before surgery, while TGF-β in observation group 1 d and 5 d after surgery was significantly lower than that before surgery, TGF-β in observation group at different time points after surgery was significantly lower than in control group （P-0.05）. IFN-γ in control group 1 d and 5 d after surgery was significantly lower than that before sur- gery, IFN-7 in observation group 5d after surgery was significantly higher than that before surgery, IFN-γ in observation group at different time points after surgery was significantly higher than in control group （P〈0.05）. Oonclusion： Ulinastatin in la

关 键 词：乌司他丁 腹腔镜手术 细胞免疫 细胞因子 

分 类 号：R608[医药卫生—外科学]