摘要
目的 :使用流式细胞仪技术 ,从T辅助细胞亚群 1、2型 (Th1/Th2 )平衡角度评价后腹腔镜肾上腺手术对术后免疫功能的影响。方法 :择期良性肾上腺腺瘤切除病人 2 8例 ,分别采用后腹腔镜手术和常规开放手术 ,测定手术前和术后 3,2 4 ,4 8hTh1、Th2细胞数量及血清白介素 - 10 (IL - 10 )、肿瘤坏死因子α(TNFα)水平。结果 :开放手术后Th1细胞、TNFα明显低于术前 ,Th2细胞、IL - 10明显升高 ,Th1/Th2、TNFα/IL - 10比值下降。腹腔镜组术后各指标均无明显变化 ,与开放组差别显著。结论 :常规开放肾上腺手术可造成术后Th1/Th2平衡明显向Th2偏移 ,使抗炎反应占优势 ,造成明显的免疫抑制。而后腹腔镜手术对Th1/Th2平衡无显著影响 ,对术后免疫功能影响小。
Objective:To investigate the immunological influences of retroperitoneal laparoscopic adrenal operation from the view of the balance of Th1 and Th2 cell detected by flow cemetery.Methods:In a prospective study, the count of the Th subsets, the serum level of IL-10 and TNFα in 14 patients submitted to retroperitoneal laparoscopic adrenal operation (RLO) and 14 patients undergoing conventional open operation (COO) were evaluated preoperatively as well as 3,24,48 hours postoperatively. Results:The level of Thl cell, TNFα and the Th1/Th2 ratio,TNF α/IL-10 ratio decreased significantly after the open surgery, but not after RLO. The postoperative level of Th2 and IL-10 increased significantly in COO group, but not RLO. The difference of the data in two groups was all significantly.Conclusions:The present study shows that open, but not retroperitoneal laparoscopic adrenal surgery is associated with a marked shift in Th1/Th2 balance to Th2 and a deregulation of the pro-inflammatory and anti-inflammatory balance. RLO has fewer influences on Th1/Th2 balance and immunologic suppression postoperatively.
出处
《中国内镜杂志》
CSCD
2002年第8期11-12,15,共3页
China Journal of Endoscopy
