【作者】 苏智雄；

【导师】 黎乐群； 彭民浩； 卢榜裕；

【作者基本信息】 广西医科大学 ， 外科学， 2002， 硕士

【摘要】 目的：观察围手术期输血对肝细胞癌（HCC）病人外周血中免疫抑制酸性蛋白（IAP）、可溶性白介素2受体（sIL-2R）、白介素6（IL-6）和T淋巴细胞亚群的动态变化，分析围手术期输血对患者机体免疫功能的影响。方法：随机选择进行HCC肿瘤切除的病人46例，分为围手术期未输血组（Ⅰ组）和围手术期输血组（Ⅱ组）。应用碱性磷酸酶-抗碱性磷酸酶法(APAAP)、单向免疫扩散法和双抗体夹心ELISA法测定患者手术前、后外周血中T淋巴细胞亚群、IAP、sIL-2R和IL-6。结果：Ⅰ组（n=19）与Ⅱ组（n=27）手术后IAP、sIL-2R和IL-6比术前升高（P<0.01或P<0.05），CD3+、CD4+淋巴细胞下降（P<0.05）；IAP术后Ⅰ组升高幅度低于Ⅱ组。结论：手术打击可使HCC患者免疫功能紊乱，而围手术期输血则可加重HCC病人术后的免疫抑制状态。更多还原

【Abstract】 Objective: The aim of this study was to investigate the changes in the levels of serum immunosuppressive acidic protein (IAP), soluble interleukin-2 receptor (sIL-2R), interleukin-6 (IL-6) and the counts of T-lymphocyte subsets in patients undergoing resection of hepatocellular carcinoma (HCC), trying to find the effects of immune function in the patients undergoing perioperative allogeneic blood transfusion.Methods: 46 patients undergoing resection of HCC, were randomly allocated to the group of non-receiving allogeneic blood transfusion (Ⅰgroup having 19 patients) and the group of receiving allogeneic blood transfusion (Ⅱgroup having 27 patients) <WP=4>during perioperative period. Alkaline phosphatase anti-alkaline phosphatase (APAAP) technique, double antibody sandwich ELISA were used to determine the counts of T-lymphocyte subsets and to detect the levels of serum sIL-2R and IL-6 on preoperative day 1 and postoperative day 4. The single radial immunodiffusion method was used to detect the serum IAP on preoperative day 1 and postoperative days 1,4,7.Results: The counts of CD3, CD4 in both groups decreased significantly after operation (P<0.05). The levels of serum IAP, sIL-2R and IL-6 in both groups elevated greatly after operation (P<0.01 or P<0.05). The increase of IAP was more obvious in Ⅱgroup than in Ⅰgroup(P<0.05).Conclusion: The operative strike contributes to the confusion of immune function in patients undergoing resection of hepatocellular carcinoma, and perioperative allogeneic blood transfusion makes it have more suppressive condition.更多还原