恶性阻塞性黄疸病人免疫抑制酸性蛋白测定的意义

Significance of determination of immunosuppressive acidic protein level in patients with malignant obstructive jaundice

目的 通过对３５ 例恶性阻黄病人（ 实验组）围减黄手术期血清免疫抑制酸性蛋白（ＩＡＰ）的测定，并与２５ 例良性阻黄病人及４０ 例正常人（ 对照组）进行比较，以了解减黄手术对病人免疫功能的影响。方法 分别于术前１ 天、术后１０ 天及术后２０ 天采集血标本，用单向免疫扩散法进行检测。结果 恶性阻黄病人血清ＩＡＰ水平术前１ 天、术后１０ 天及２０ 天明显高于良性阻黄病人及正常人（Ｐ＜０－０１） ；良、恶性阻黄病人术后短期（１０ 天）ＩＡＰ呈一过性增高，随病情恢复，ＩＡＰ水平逐渐下降，术后２０ 天良性阻黄病人与正常人相比无显著差异（ Ｐ＞ ０－０５），恶性阻黄病人仍处于较高水平。结论 恶性阻黄病人外周血中免疫抑制物ＩＡＰ明显增高，病人免疫功能受到明显抑制而低下，减黄术可不同程度地改善病人的免疫功能。

Objective To evaluate changes in immune function in patients with malignant obstructive jaundice. Methods The immunosuppressive acidic protein (IAP) levels were determined dynamically by one directional immunodiffusion test in peripheral blood from 35 preoperative patients with malignant obstructive jaundice (MOJ), then compared them with those of 40 normal subjects and 25 cases of benign obstructive jaundice (BOJ) separately. Results The IAP level in MOJ was obviously higher than that in BOJ and normal control groups both before and after operation (P<0.01). IAP level in MOJ decreased temporarily after operation, then increased slowly in recovery period. Twenty days after operation, there was no significant difference in IAP level between healthy control and BOJ groups (P>0.05), while in MOJ it still remained higher than in other two groups. Conclusion The IAP level decreases obviously and the cellular immunologic function is low in MOJ. Surgical therapy could improve immunologic function in varying degrees.