围手术期应用乌司他丁治疗对肝细胞癌患者肝切除术后外周血Th22细胞百分比和血浆白细胞介素-22的影响  

Peripheral blood Th22 cells and plasma interleukin-22 level changes in patients with hepatocellular carcinoma after hepatectomy and administration of ulinastatin

作　　者：朱俊 丁莹 王世清 张野 刘野[3] 刘泽刚 Zhu Jun;Ding Ying;Wang Shiqing(Department of General Surgery,General Hospital of PLA,Kunming 650032,Yunan Province,China)

机构地区：[1]解放军昆明总医院普通外科,昆明市650032 [2]空军军医大学唐都医院感染病科 [3]解放军第208医院重症医学科

出　　处：《实用肝脏病杂志》2019年第5期720-723,共4页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(编号：81671555)

摘　　要：目的观察围手术期应用乌司他丁对肝细胞癌(HCC)肝切除手术患者术后外周血Th22细胞百分比和血浆白细胞介素(IL)-22水平的影响。方法2015年7月~2017年4月解放军昆明总医院普通外科行肝切除手术的HCC患者88例,术后51例接受常规治疗,37例另加乌司他丁治疗7 d。另选30例健康人作为对照。分离外周血单个核细胞(PBMC),使用流式细胞术检测CD3+CD4+IL-22+的Th22细胞百分比,采用ELISA法检测血浆IL-22水平。对符合正态分布的计量资料比较采用独立样本t检验,对于非正态分布的计量资料比较采用Mann-Whitney检验。结果HCC患者外周血Th22细胞百分比为(1.4±0.3)%,显著高于健康人【(0.8±0.1)%,P<0.0001】;HCC患者血浆IL-22水平为(116.9±32.6)pg/ml,亦显著高于健康人【(42.1±18.2)pg/ml,P<0.0001】;在术后3 d,乌司他丁治疗组和常规治疗组血清ALT分别为【219.4(40.1,510.9)IU/L和450.6(56.1,820.7)IU/L,P<0.05】,血清AST分别为【108.8(82.5,439.1)IU/L和257.3(115.3,7265)IU/L,P<0.01】;在术后7 d,乌司他丁治疗组和常规治疗组血清ALT分别为【72.4(25.6,471.5)IU/L和115.4(35.7,625.2)IU/L,P<0.05】,血清AST分别为【61.4(29.4,351.4)IU/L和90.5(45.5,293.8)IU/L,P<0.05】;术后3 d和术后7 d,乌司他丁治疗组外周血Th22细胞百分比分别为(1.2±0.4)%和(1.1±0.3)%,较常规治疗组显著降低【分别为(1.3±0.3)%,P<0.05和(1.3±0.2)%,P<0.05】;血浆IL-22水平分别为(98.1±20.1)pg/ml和(94.1±24.8)pg/ml,亦较常规治疗组显著降低【分别为(109.7±29.8)pg/ml,P<0.05和(110.7±37.1)%,P<0.05】。结论肝切除术后应用乌司他丁治疗可降低外周血Th22细胞比例和血浆IL-22水平,对肝功能具有一定的保护作用.Objective To investigate peripheral blood Th22 cells and plasma interleukin-22(IL-22)level changes in patients with hepatocellular carcinoma(HCC)after hepatectomy and administration of ulinastatin.Methods A total of 88 patients with HCC were recruited in Department of General Surgery,Kunming General Hospital of PLA between July 2015 and April 2017,and all patients underwent hepatectomy.After the operation,51 received routine supporting therapies and 37 received ulinastatin treatment for seven days.Thirty healthy individuals were also enrolled serving as normal controls(NC).Peripheral blood mononuclear cells(PBMC)and plasma were isolated and percentage of CD3+CD4+IL-22+Th22 cells were investigated by flow cytometry,and plasma IL-22 levels was measured by enzyme linked immunosorbent assay.The differences of Th22 percentages and IL-22 levels were compared between patients with HCC and NC.The independent samples t test was used for comparison of normally distributed continuous data,and Mann-Whitney test was used for comparison of continuous data with skewed distribution.Results Peripheral blood Th22 cell percentage in HCC patients was(1.4±0.3)%,significantly elevated than that in NC[(0.8±0.1)%,P<0.0001];plasma IL-22 level in HCC patients was(116.9±32.6)pg/ml,significantly higher than that in NC(42.1±18.2)pg/ml(P<0.01);serum ALT level in ulinastatin-treated group and routine treatment group were[219.4(40.1,510.9)IU/L and 450.6(56.1,820.7)IU/L,P<0.05]at the end of 3 days post-operation,and serum AST level in ulinastatin-treated group and routine treatment group were[108.8(82.5,439.1)IU/L and 257.3(115.3,7265)IU/L,P<0.01],respectively;serum ALT level in ulinastatin-treated group and routine treatment group were[72.4(25.6,471.5)IU/L and 115.4(35.7,625.2)IU/L,P<0.05]at the end of 7 days post-operation,and serum AST level in ulinastatin-treated group and routine treatment group were[61.4(29.4,351.4)IU/L and 90.5(45.5,293.8)IU/L,P<0.05],respectively;peripheral blood Th22 cell percentages were(1.2±0.4)%and(1.1±0.3)%at

关 键 词：肝细胞癌 肝切除术 乌司他丁 TH22细胞 白细胞介素-22 

分 类 号：R73[医药卫生—肿瘤]