梗阻性黄疸患者细胞免疫功能的改变

THE VARIATIONS OF CELL-MEDIATED IMMUNITY FUNCTION IN PATIENTS WITH OBSTRUCTIVE JAUNDICE

本文观察１２例梗阻性黄疸患者在围手术期免疫功能的变化。结果提示，黄疸期患者血清ＴＮＦ和经ＬＰＳ诱生的ＴＮＦａ水平明显高于成年健康对照者，中性粒细胞吞噬和杀菌功能则显著低于对照者，静息淋巴细胞群中ｍＩＬ－２Ｒ＋细胞百分率以及Ｔ和Ｂ淋巴细胞数无多改变。当黄疸消退后第七天，患者血清ＴＮＦ和ＴＮＦａ水平即迅速下降，接近正常水平，中性粒细胞功能随黄疸消失而逐渐增加，至第３０天基本恢复正常，其余指标无明显改变。文中列举典型病例的４项免疫参数的动态变化，提示患者血清ＴＮＦ和ＴＮＦａ水平与中性粒细胞功能呈负相关。

Variations of cell-mediated immunity function were determined in12 patients with obstructive jaundice at the perioperative period. The results showed that the serum TNF level and TNFa induced by LPS were markedly elevated in the icteric phase of patients in comparison with of healthy adult control. The phagocytic and bacteriocidal function of neutrophils were significantly declined. percentages of mIL-2R+ cells in the resting lymphocyte populations were also markedly elevated, but those of the inducely expressing mIL-2R+ lymphocytes, as well as the numbers of T and B lymphocytes showed no change. Seventh day afteer the subsidence of jaundice, the serum TNF and TNFa level were rapidly declined to normal level,and the neutrophil functions were gradually elevated, turning up to 30th day after subsidence of jaundice. The other indicators were not significantly changed. The dynamic variation of the orber 4 items of immunologic parameters in typical cases were exampled. These experimental results suggested that the serum TNF and TNFa level had a negative correlation with the neutrophil functioms.