【摘要】 目的探讨脾多肽注射液对手术老年直肠癌患者术后淋巴细胞亚型的影响。方法前瞻性的收集2016年1月至2017年12月就诊于山西省肿瘤医院结直肠外科的老年直肠癌患者(65周岁及以上患者)148例,按照随机数字表法分为对照组及干预组,每组均有74例。对照组给予手术、营养支持、补液、抑酸、伤口清洁换药等常规治疗,干预组在对照组的基础上于手术当日开始给予脾多肽注射液静脉滴注10 d。分别比较2组患者术后并发症的情况,并且在手术前3 d及手术后21 d外周血中免疫细胞分别占淋巴细胞的百分比。结果 2组患者在手术前的一般资料、淋巴细胞亚型及CD4+T细胞/CD8+T细胞差异均无统计学意义(P>0.05)。2组患者手术后的并发症发生情况差异无统计学意义(P>0.05)。2组患者的CD4+T细胞、Treg细胞比例及CD4+T细胞/CD8+T细胞差异有统计学意义(P<0.05)。与手术前相比,术后对照组CD3+T细胞、CD4+T细胞比例及CD4+T细胞/CD8+T细胞降低(P<0.05),CD8+T细胞比例升高(P<0.05),自然杀伤细胞(NK细胞)(P=0.603)及调节性T细胞(Treg细胞)(P=0.801)比例差异无统计学意义。术后干预组CD4+T细胞、Treg细胞比例及CD4+T细胞/CD8+T细胞降低(P<0.05),CD8+T细胞比例升高(P=0.004),CD3+T细胞(P=0.428)及NK细胞(P=0.079)比例差异无统计学意义。结论脾多肽可以调节免疫细胞占淋巴细胞的百分比,改善老年直肠癌患者术后的免疫功能。更多还原

【Abstract】 Objective To investigate the effect of lienal polypeptide injection on lymphocyte subtypes of postoperative peripheral blood in elderly patients with rectal cancer. Methods The clinical data of 148 elderly patients(aged over 65 years old) with rectal cancer admitted to Shanxi Provincial Cancer Hospital between January 2016 and December 2017 were prospectively included. All patients were randomly divided into the control group and interven-tion group, with 74 patients in each group. The control group received conventional treatment, such as surgery, nutri-tional support, rehydration, acid suppression, and wound cleansing and dressing change. In addition, the intervention group was givenintravenous infusion of lienal polypeptide for 10 days from the first day of operation. The postoperative complications were compared between the two groups.The percentage of immune cells tolymphocytes in peripheral blood at 3 d before the operationwas compared with that at 21 d after the operation.Results There were no statistical differences in the general data, lymphocyte subtype and CD4+T cells/CD8+T cellsat the baseline between the two groups(P>0.05). There were no significant differences in postoperative complications between the two groups(P>0.05).There were statistical differences in the proportion of CD4+T cells and regulatory T cell(Treg) cells and CD4+T cells/CD8+T cells between the two groups(P<0.05). After the operation, the proportion of CD3+T cells and CD4+T cells and CD4+T cells/CD8+T cells in the control group reduced compared with those at the baseline(P<0.05), whereas the proportion of CD8+T cells increased(P<0.05), and no significant differences were found in the proportions of natural killer(NK) cells(P=0.603) and Treg cells(P=0.801). After the operation, the proportion of CD4+T cells and Treg cells and CD4+T cells/CD8+T cells decreased in the intervention group(P<0.05), whereas the proportion of CD8+T cells increased(P=0.004), and no significant differences were found in the proportions of CD3+T cells(P=0.428) and NK cells(P=0.079). Conclusion Lienal polypeptide may regulate the percentage of immune cells to lymphocytes and improvepostoperative immune function of geratic rectal cancer.更多还原