胸腺肽α1对原发性肝癌围手术期免疫功能的影响

Effects of thymosin α1 on immune function in perioperative patients with primary liver cancer

目的:研究胸腺肽αⅠ对原发性肝癌患者围手术期免疫功能的影响．方法:103例确诊为原发性肝癌患者分为2组,A组采用胸腺肽a1+手术治疗(n=35),B组仅手术治疗(n=68)．胸腺肽α1治疗前后及手术前、手术后7,14,21 d用流式细胞仪检测CD3+,CD4+,CD8+,CD8+CD28+,CD16+CD56+ 的变化,MTTI比色法测定IL-2活性．结果:A组CD8+,CD4+/CD8+,CD8+CD28+,CD16+CD56+ 及IL-2均明显低于正常对照组(F=8．2,P=0．005); 术前经胸腺肽α1治疗后CD4+／CD8+,CD16+CD56+较治疗前增高(F=8．4,P=0．004);术后7 d CD4+／CD8+, CD8+CD28+,CD16+CD56+较术前增高(F=4．7,P=0．005 或F=3．5,P=0．04),术后14 d IL-2也增高(F=3．6、P= 0．03)．B组术后7 d,CD4+,CD8+,CD4+／CD8+,CD8+CD28+, CD16+CD56+较术前明显降低(F=5．4,P=0．006或F= 3．6,P=0．02),术后14 d,CD8+,CD8+CD28+仍然低于术前(F=5．0,P=0．007),其他指标有所恢复:术后21 d, CD8+仍未恢复至术前水平(F=6．3,P=0．000);B组术后 7 d,CD3+,CD8+,CD4+／CD8+,CD8+CD28+,CD16+CD56+ 均明显低于A组(F=7．2,P=0．001)．结论:肝癌患者存在免疫抑制,术后早期免疫抑制程度加重,围手术期胸腺肽α1治疗可有效改善肝癌围手术期免疫抑制状况．

AIM： To investigate the immune state of patients with primary hepatic carcinoma （PHC） liver cancer after treatment with thymosin al during perioperative period. METHODS： One hundred and three patients with PHC were divided into two groups, The patients in group A （n = 35） received hepatectomy plus thymosin α1 treatment and the patients in group B （n = 68） underwent hepatectomy only, Twenty normal blood donors were used as controls. Before and 7, 14, and 21 d after treatment, the changes of serum CD3^＋, CD4^＋CD8^＋, CD8^＋CD28^＋, and CD16^＋CD56^＋ were measured by flow cytometry. MTT colometric assay was performed to detect the activity of interleukin-2 （IL-2）.RESULTS： Before hepatectomy and thymosin α1 treatment, serum CD8^＋, CD4^＋/CD8^＋, CD8^＋CD28^＋, CD16^＋/ CD56^＋ and IL-2 were markedly lower in group A than that in the controls （F = 8.2, P = 0.005）, while after treatment, serum CD4^＋/CD8^＋, CD16^＋CD56^＋ were significantly increased （F = 8.4, P = 0.004）. Seven days after hepatectomy, serum CD4^＋/CD8^＋, CD8^＋CD28^＋, CD16^＋/CD56^＋ were elevated （F = 4.7, P = 0.005 or F= 3.5, P = 0.04）, and 14 d after hepatectomy, the level of serum IL-2 was inceased （F = 3.6, P = 0.03）. For group B, serum CD4^＋, CD8^＋, CD4^＋/CD8^＋, CD8^＋/CD28^＋, CD16^＋/CD56^＋ were notably reduced 7 d after hepatectomy （F = 5.4, P = 0.006 or F = 3.6, P = 0.02）. The levels of serum CD8^＋ and CD8^＋/CD28^＋ were still lower （F = 5.0, P = 0.007） at 14 d than those before operation, but the levels of CD4^＋, CD4^＋/CD8^＋, and CD16^＋/CD56^＋ restored to some extent. At 21 d, serum CD8^＋ level still didn＇t restore （F = 6.3, P = 0.000）. The levels of serum CD3^＋, CD8^＋, CD4^＋/ CD8^＋, CD8^＋/CD28^＋, CD16^＋/CD56^＋ were all lower in group B than those in group A （F = 7.2, P = 0.001）. CONCLUSION： The immunosuppression exists in patients with PHC, and it can be aggravated in early stage after hepatectomy. However, the immunosuppression can be alleviated by thymosin α1 treatment during perioperative period.