胆道梗阻患者血清IL-2活性和SIL-2R表达及西米替丁调节作用的研究

Clinical study on serum levels of soluble interleukin-2 and interleukin-2 receptor in patients with biliary obstruction and the therapeutic effects of cimetidine

目的探讨胆道梗阻患者围手术期血清白细胞介素-2(IL-2)活性和可溶性白细胞介素-2受体(SIL-2R)水平及西米替丁的免疫调节作用。方法30例胆道梗阻患者(良性21例,恶性9例),分别采用放免计数器和双抗体夹心ELISA法测定血清IL-2和SIL-2R水平。另择一组良性胆道梗阻患者术前行为期7天的西米替丁治疗,检测其血清IL-2及SIL-2R水平的变化。结果1、良恶性两组术前血清IL-2较对照组明显降低,SIL-2R明显高于对照组,术后逐渐恢复,但良恶性两组变化幅度差异明显;2、血清总胆红素水平与血清IL-2及SIL-2R水平之间密切相关;3、西米替丁可上调良性胆道梗阻患者血清IL-2水平,抑制血清SIL-2R过表达。结论胆道梗阻时血清IL-2活性降低和SIL-2R过度表达,检测血清IL-2和SIL-2R有助于估价病情、判断预后及鉴别胆道梗阻的性质,西米替丁通过提高血清IL-2活性,抑制血清SIL-2R表达而发挥其免疫调节作用。

Objective To evaluate serum interleukin-2 （IL-2） and soluble interleukin-2 receptor （SIL-2R） concentration and its clinical significance in patients with biliary obstruction and the immune adjustment of cimetidine. Methods The patients with biliary obstruction were divided into benign group and malignant group, serum IL-2 and SIL-2Rconcentrations of the two groups were dynamically measured in 30 patients with biliary obstruction by radioimmunoassay and ELISA. 25 benign patients with biliary obstruction were treated in seven days by cimetidine, to observe the changes of preoperative serum IL-2 and SIL-2R concentrations. Results Preoperative serum IL-2 comcentration of the two groups wa significantly lower but the level of SIL-2R was siginificantly higher than those of normal control subjects while postoperative serum levels of IL-2 and SIL-2R resume gradually. But there was a significant differece in the trend between benign and malignant ictefic patients. The rank correlation analysis showed a relationship between the serum level of bilirubin and serum lev- els of IL-2 and SIL-2R. Cimetidine can advance significantly serum level of IL-2, restrain serum SIL-2R concentration of the benign patients with biliary obstruction. Conclusions There exist low activity of IL-2 and high expression level of SIL-2R in patients with biliary obstruction. Examination of serum IL-2 and SIL-2R comcentration might be a valuable parameter of estimating patientis conditions, assessing patients prognosis and identifying the nature of biliary obstruction. Cimetidine might take the immune adjustment effects on the biliary obstruetive cases by elevating serum activity of IL-2, inhibiting high expressive level of SIL-2R.