宫颈癌术后感染患者T淋巴细胞免疫功能变化及其临床意义  

Changes of T lymphocytes immune functions of cervical cancer patients with postoperative infections and analysis of clinical significance

作　　者：谭细凤[1] 徐慧君[1] 郭丽华[1] 谷雨枫 邰立志[1] 段跃[1] 

机构地区：[1]武警浙江省总队嘉兴医院妇科,浙江嘉兴314000

出　　处：《中华医院感染学杂志》2015年第6期1270-1272,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(Y2110467)

摘　　要：目的：探讨宫颈癌患者手术前后及术后发生感染时 T 淋巴细胞免疫功能的变化，以指导术后临床药物的使用。方法选择2012年10月－2013年9月在妇科宫颈癌Ⅰ A ～Ⅱ A 期行广泛子宫切除＋盆腔淋巴结清扫术患者50例，其中33例术后无感染患者为手术Ⅰ组，17例合并术后感染患者为手术Ⅱ组；另选取20名健康女性为对照Ⅰ组及20例子宫肌瘤行全子宫切除术患者为对照Ⅱ组，采用 ELISA 法检测各组血清中γ干扰素（IFN-γ）、白细胞介素2（IL-2）和肿瘤坏死因子α（TNF-α）；采用流式细胞术检测外周血中 IFN-γ＋ CD4＋、IL-2＋ CD4＋和TNF-α＋ CD4＋等 T 淋巴细胞亚群。结果手术Ⅰ、Ⅱ组的宫颈癌患者 IFN-γ＋ CD4＋、IL-2＋ CD4＋和 TNF-α＋CD4＋ T 淋巴细胞及其分泌的 IFN-γ、IL-2和 TNF-α水平在术前显著低于对照Ⅰ、Ⅱ组（P＜0．05）；手术Ⅰ、Ⅱ组的以上各项免疫指标在术后显著升高（P＜0．05），且术后合并感染的手术 Ⅱ组明显高于未合并感染的手术Ⅰ组（P＜0．05）。结论宫颈癌患者体内 T 淋巴细胞分泌细胞因子功能受抑制；术后 T 淋巴细胞免疫功能有恢复趋势，而感染进一步增强免疫反应。OBJECTIVE To observe the changes of the t lymphocytes immune functions of the cervical cancer pa-tients with postoperative infections before and after the surgery so as to provide guidance for the clinical use of an -tibiotics .METHODS A total of 50 patients with cervical cancer ranging between phase Ⅰ A and Ⅱ A who under-went extensive hysterectomy plus pelvic lymphadenectomy in the gynecology department from Oct 2012 to Sep 2013 were enrolled in the study ,among whom 33 patients without postoperative infections were assigned as the surgery group Ⅰ and 17 patients complicated with postoperative infections were set as the surgery group Ⅱ . While 20 healthy females were chosen as the control group Ⅰ ,and 20 patients with uterine fibroids who under-went hysterectomy were set as the control group Ⅱ .The levels of the serum interferon γ（IFN-γ） ,interleukIn 2 （IL-2） ,and tumor necrosis factorα（TNF-α） were determined by using ELISA ;the levels of the T lymphocytes subsets in peripheral blood ,including the IFN-γ ＋ CD4 ＋ ,IL-2 ＋ CD4 ＋ ,and TNF-α ＋ CD4 ＋ ,were measured with the use of flow cytometry .RESULTS Before the surgery ,the levels of IFN-γ ＋ CD4 ＋ ,IL-2 ＋ CD4 ＋ ,TNF-α ＋CD4 ＋ ,IFN-γ ,IL-2 ,and TNF-α were significantly lower in the surgery group Ⅰ and the surgery group Ⅱ than in the control group Ⅰ and the control group Ⅱ （P〈 0 .05） ;the levels of the above immunological indicators of the surgery group Ⅰ and the surgery group Ⅱ were remarkably elevated after the surgery （P〈 0 .05） ,and the levels of the immunological indicators of the patients complicated with postoperative infections in the surgery group Ⅱwere significantly higher than those of the patients without postoperative infections in the surgery group Ⅰ （P〈0 .05） .CONCLUSION The function of secretion of cytokines of the t lymphocytes in the cervical cancer patients is inhibited ;the T lymphocytes immune function shows a trend of recovery after the surgeries , howev

关 键 词：宫颈癌 感染 T 淋巴细胞 细胞免疫 

分 类 号：R446.63[医药卫生—诊断学]