老年结直肠癌手术前后免疫功能的变化  

Pre and Post-operative Changes of Immunity in Elderly Patients with Colorectal Cancer

作　　者：杜卫东[1] 袁祖荣[1] 沈达明[1] 钱敏[1] 唐健雄[1] 程爱群[1] 刘军[1] 黄春锦[1] 

机构地区：[1]上海市华东医院普外科,200040

出　　处：《腹部外科》2003年第5期290-292,共3页Journal of Abdominal Surgery

摘　　要：目的　探讨老年结直肠癌病人手术前后免疫状况的变化。方法　对我院 6 0岁以上行根治性手术的 6 8例结直肠癌病人进行手术前后细胞免疫和体液免疫的检测 ,并将之与健康老年对照组和年轻结直肠癌病例进行比较。结果　老年结直肠癌病人手术前CD4、CD4 /CD8和NK细胞水平低于健康老年人群和年轻病人 ,而CD8、TNF α和SIL 2R水平较健康老年人群和年轻病人明显增高。手术后 2周年轻病人的CD4、CD4 /CD8和NK细胞水平较手术前升高 ,CD8、TNF α和SIL 2R水平降低 ;而老年病人除TNF α和SIL 2R水平显著降低外 ,各项免疫学指标无显著变化。老年结直肠癌病人手术前IgM、IgA和IgG水平低于健康老年人群。手术后 2周年轻病人的IgM、IgA、C3 和C4水平增高 ,而老年病人较术前无变化。结论　针对老年病人的免疫特点 ,加强围手术期处理 ,改善老人的营养情况 ,必要时结合有效的生物治疗 ,及时提高病人的免疫功能 。Objective To investigate the pre and post operative changes of immunity in elderly patients with colorectal cancer. Methods From Jan. 1998 to Dec. 2002, TNF α, SIL 2R, IgG, IgM, IgA, C 3, C 4, NK cells and T cell subgroups of 68 elderly patients with colorectal cancer were measured 1 day before operation and 14 days after operation. Results The levels of CD4, CD4/CD8 and NK cells were lower and the levels of CD8, TNF α and SIL 2R were higher in elderly patients with colorectal cancer than those of the young patients and the normal old people before operation. The levels of CD4, CD4/CD8, NK cells, IgM, IgA, C 3 and C 4 were raised and the levels of CD8, TNF α and SIL 2R decreased in the young patients with colorectal cancer 2 weeks after operation. However, in the elderly patients all these results did not change except the levels of TNF α and SIL 2R. Conclusion To enhance immune function is essential to elderly patients with colorectal cancer during the operation.

关 键 词：结直肠 直肠癌 结肠癌 外科手术 手术前后 免疫功能 细胞免疫 体液免疫 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]