急性胰腺炎患者治疗前后T细胞亚群的变化及意义

Changes of T lymphocyte subsets before and after treatment of acute pancreatitis and its clinical significance

目的:探讨急性胰腺炎(AP)患者治疗前后细胞免疫功能的变化。方法:对我院2007至2009年收治的32例AP患者在治疗前、后(血尿淀粉酶恢复正常后)抽取外周血,同时抽取12例健康成人外周血作对照,流式细胞术测定T淋巴细胞亚群,观察CD3+、CD4+、CD8+百分比以及CD4+/CD8+值的变化。结果:32例AP患者CD3+、CD4+百分比及CD4+/CD8+值与对照组比较明显下降(P<0.01或P<0.05);其中重症组CD4+百分比和CD4+/CD8+值较轻症组明显下降(P<0.01);经内科综合治疗后,重症组治疗前、后比较CD4+百分比及CD4+/CD8+值升高明显(P<0.01);轻症组治疗前、后比较CD4+百分比也有所增加(P<0.05)。结论:AP患者特别是重症AP患者存在细胞免疫功能损害,经过治疗后可恢复正常,提示免疫调节治疗可能有助于重症AP的恢复。

Objective：To discuss the changes of the cellular immunity function in patients with acute pancreatitis before and after treatment.Methods：Determination of CD 3＋,CD 4＋ and CD 8＋ percentage was made by FCM in 32 patients with acute pancreatitis before and after routine treatment（after blood and urine amylase came back normal）,and 12 healthy adults were detected as normal control group.Results：Percentage of CD 3＋ cell was lower in all patients with acute pancreatitis（P 0.05）,and percentage of CD 4＋ cell and CD 4＋ /CD 8＋ ratio were lower in severe acute pancreatitis（SAP） patients compared with healthy adults（P 0.01）.But after treatment,percentage of CD 4＋ cell and CD 4＋ /CD 8＋ ratio sharply increased in SAP and mild acute pancreatitis（MAP）（P 0.01）.Conclusion：The patients with acuter pancreatitis,especially with SAP,exist some degree cellular immunity function deficiency.And after general treatment,the cellular immunity function came bake normal,so adjustable immunotherapy may bring some effect on SAP.