摘要
目的探讨腹腔镜手术治疗结直肠癌对机体免疫状态的影响。方法2004年3月至2004年12月,同一手术组将可手术治疗的结直肠癌患者60例,随机分为腹腔镜手术组和开放手术组,每组各30例。分别在术前1d和术后3、7d取外周静脉血,测定C反应蛋白(CRP)、免疫球蛋白(Ig)A、IgM、IgG,CD3+、CD4+、CD8+、自然杀伤细胞(NK细胞)和CD4+CD45RA+、CD4+CD45RO+细胞及血淋巴细胞数并进行比较。结果开放手术组术后3d外周血淋巴细胞数(1.09±0.29)×109/L,CD4+细胞(0.54±0.14)×109/L,CD8+细胞(0.31±0.08)×109/L,CD4+CD45RO+细胞(61.1±8.9)%,IgM(136.9±52.8)IU/ml,IgG(115.2±45.7)IU/ml;术后7dCD8+细胞(0.32±0.09)×109/L,CD4+CD45RO+细胞(63.2±9.1)%,均明显低于术前(P<0.05,P<0.01)。而腹腔镜手术组术后3d除CD4+CD45RO+细胞犤(62.7±12.5)%犦较术前降低(P<0.05)外,其余免疫学指标无明显降低;而淋巴细胞数犤(1.29±0.37)×109/L犦、IgM犤(164.5±48.2)IU/ml犦和CD8+细胞数犤(0.38±0.09)×109/L犦与开放手术组比较,差异有统计学意义(P<0.05)。结论腹腔镜手术治疗结直肠癌比开放手术在免疫功能保护上更具有优势。
Objective To compare the effect of laparoscopic radical operation and open operation on systemic immunity in patients with colorectal cancer. Methods Sixty patients with colorectal cancer were randomly divided into laparoscopic and open operation groups from March 2004 to December 2004, each group had 30 cases. CRP, IgA, IgM, IgG, CD3 ^＋ cells, CD4^＋ cells, CD8^＋ cells, NK cells, CD4^＋CD45RA^＋ cells, CD4 ^＋CD45RO ^＋ cells and lymphocytes in peripheral blood were counted and compared on the 1st day before operation, 3rd and 7th day after operation. Results The two groups were comparable as for age, tumor location and stages. In open operation group, lymphocyte counts were （1.09± 0. 29） × 10^9/L,C D4^＋ cell （0. 54±0. 14） × 10^9/L,CD8^＋ cell （0. 31±0.08） × 10^9/L,CD4 ^＋CD45RO^＋ cell （61.1± 8.9）% ,and IgM level （136. 9± 52.8） IU/ml, IgG （115.2± 45.7） IU/ml on the 3rd day after operation, CD8 ^＋ cell counts were （0. 32± 0.09） × 10^9/L, CD4^＋CD45RO^＋ cell （63.2± 9.1）% on the 7th day after operation, were all significantly lower than those on the 1st day before operation respectively（ P 〈 0.05, P 〈0.01）. In laparoscopic operation group, the decreases of such parameters except CD4 ^＋CD45RO ^＋ cell （62. 7 ± 12.5 ）% were not obvious on the 3rd day after operation. There were significant difference in lymphocyte counts （1.29±0.37） × 10^9/L, IgM（164.5± 48.2） IU/ml and CD8 ^＋ cell counts （0. 38± 0.09） × 10^9/L on the 3rd day after operation between two groups（P 〈 0.05） . Conclusion Compared with open radical operation, laparoscopic radical operation has predominance in protecting systemic immunity to treat colorectal carcinoma.
出处
《中华胃肠外科杂志》
CAS
2005年第5期407-409,共3页
Chinese Journal of Gastrointestinal Surgery
