精氨酸对胰腺癌介入治疗患者血清sTNFR-1与T淋巴细胞rDNA转录活性的影响

Effect of Arginine on Serum Tumor Necrosis Factor Receptor 1(sTNFR-1) and Tlymphocytes rDNA Transcription Activity in Peripheral Blood of Patients with Pancreatic Cancer after Intra-arterial Chemotherapy

目的探讨精氨酸增强的胃肠外营养对胰腺癌患者介入治疗术后血清可溶性肿瘤坏死因子受体1(sTNFR-1)和T淋巴细胞rDNA转录活性水平的影响及其临床意义。方法分别用酶联免疫法(ELISA)和核仁形成区相关蛋白银染技术测定50例中晚期胰腺癌患者(胰腺癌组)行动脉栓塞化疗术治疗前后血清sTNFR-1和外周血T淋巴细胞rDNA转录活性的改变,并与健康对照组比较分析。结果胰腺癌组介入治疗前sTNFR-1增高,外周血T淋巴细胞rDNA转录活性降低,与对照组比较差异有极显著性(P<0.01);行化疗栓塞术后,患者血清sTNFR-1降低,外周血T淋巴细胞rDNA转录活性增高,治疗前后差异有显著性(P<0.05);应用精氨酸治疗组较未用组血清sTNFR-1下降和外周血T淋巴细胞rDNA转录活性升高更显著(P<0.05)。结论检测胰腺癌患者血清sTNFR-1和外周血T淋巴细胞rDNA转录活性的水平,有助于了解患者的免疫状况,介入治疗辅以合理的免疫营养素能增强患者的免疫功能。

Objective To study the effects and clinical significance of arginine on serum soluble tumor necrosis factor receptor 1 （ sTNFR-1 ） and T-lymphocytes rDNA transcription activity in peripheral blood of patients with pancreatic cancer after intra-arterial chemotherapy Methods The level of sTNFR-1 and T-lymphocytes rDNA transcription activity in peripheral blood of 50 patients with pancreatic cancer before and after intra-arterial chemotherapy were measured by ELISA and a cell image analysis of Ag-NORs respectively, and compared with that of health controls. Results Before intra-arterial chemotherapy ,the level of sTNFR-1 was higher while T-lymphocytes rDNA transcription activity of PBL was lower than that of health controls（ P 〈 0.01）. After intra-arterial chemotherapy, sTNFR-1 declined while T-lymphocytes rDNA transcription activity elevated （P 〈 0.05 ）. The effects in the group combined with immune nutrition therapy （arginine） was more obvious than that in the group without （P 〈 0. 05 ）. Conclusion sTNFR-1 and T-lymphocytes rDNA transcription activity is helpful to evaluate the patients immune state. The intra-arterial chemotherapy combined with suitable immune nutrition therapy can improve immune function of the patients with pancreatic cancer.