铜绿假单胞菌制剂腹腔给药对进展期胃癌患者细胞免疫水平的影响

Effects of intraabdominal administration of pseudomonas acerug vaccine on cytoimmunity in advanced gastric cancer patients

目的评价术中铜绿假单胞菌注射液腹腔置药对胃癌患者细胞免疫功能的影响及安全性。方法将72例进展期胃癌患者随机分为铜绿假单胞菌腹腔置药组（实验组，41例）和对照组（31例）。实验组术毕于瘤床放置铜绿假单胞菌注射液8～10ml。分别在术前、术后10、20、30d采集两组患者的静脉血测定淋巴细胞总数、淋巴细胞亚群，观察患者围手术期并发症及药物不良反应。结果实验组淋巴细胞总数[（1．77±0．58）×10^9／L]与对照组[（1．61±0．52）×10^9／L]比较明显提高，差异有统计学意义（P=0．042）；实验组CD3＋细胞（76．36±9．47）与对照组（68．63±10．34）比较明显提高，差异有统计学意义（P=0．027）；实验组NK细胞（14．92±8．65）与对照组（14．61±10．31）比较明显提高（P=0．012），差异有统计学意义（P=0．027）；实验组CD8＋细胞（30．89±9．89）与对照组（30．53±9．26）比较明显下降，差异有统计学意义（P=0．037），而两组的CD4＋细胞数和CD4＋／CD8＋相比差异无统计学意义（均P〉0．05）。铜绿假单胞菌注射液对患者的血常规及肝、肾功能均无明显影响，实验组的1年生存率（94．9％）高于对照组（83．3％），两组相比差异有统计学意义（P=0．022）。结论铜绿假单胞菌注射液的腹腔给药方式安全可行，对进展期胃癌患者具有明显的免疫调节作用。

Objective To evaluate the safety and effects of pseudomonas aerug PA-MSHA vaccine on cytoimmunity in advanced gastric cancer patients. Methods Seventy two patients with advanced gastric cancer were randomly divided into experimental group and control group. Tumor bed was treated intraoperatively by pseudomonas vaccine injection in experimental group. The venous bloods were sampled prior to surgery （preoperative） and on days 10, 20, and 30 postoperatively. The total lymphocyte count and lymphocyte subpopulations were detected while the postoperative complications and adverse drug reaction were observed, prognosis was evaluated. Results The total lymphocyte count（P = 0. 042） and the counts of CD3＋ lymphocyte （ P = 0. 027 ） and NK cell increased （ P = 0. 012 ） obviously in experimental group. CD8 ＋ lymphocyte decreased（ P = 0. 037 ）, but the counts of CD4 ＋ lymphocyte and CD4＋/CD8 ＋ were not significantly different. Complications were not significantly different in the two groups. One year survival rate was longer （ 94. 9% ） in experimental group than that in the control group （ 83. 3% ） （ P - 0. 022 ）. Condusions Peritoneal cavity administration with pseudomonas aerug vaccine was safe, and effectively helps regulate eytoimmunity in postoperative patients of advanced gastric carcinoma.